Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 030947 | NY |
NPI | 1487988739 |
---|---|
Provider Name | Mr. Evgeny Shenker |
First Address | New York, NY 10010-7453 |
Second Address | New York, NY 10003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2009 |
Last Update Date | 01/03/2017 |