Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 014158 | NY |
NPI | 1194026856 |
---|---|
Provider Name | Mr. Kesler Carrie |
First Address | Uniondale, NY 11553-3239 |
Second Address | Uniondale, NY 11553-3239 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2010 |
Last Update Date | 11/11/2010 |