Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 012457-1 | NY |
N | 2251G0304X | Physical Therapist - Geriatrics | 012457-1 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 012457-1 | NY |
NPI | 1295980282 |
---|---|
Provider Name | Mr. Harry Franco Divino Francisco |
First Address | Yonkers, NY 10710-3116 |
Second Address | Yonkers, NY 10710-3116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2008 |
Last Update Date | 18/11/2008 |