Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 029931 | NY |
N | 2251N0400X | Physical Therapist - Neurology | ||
N | 2251X0800X | Physical Therapist - Orthopedic | 029931 | NY |
NPI | 1467635136 |
---|---|
Provider Name | Mr. Garry Cowell |
First Address | New York, NY 10028-2175 |
Second Address | New York, NY 10128-5289 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2007 |
Last Update Date | 27/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1215159355 | GROUP NPI # (01) | NY |