Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 024344-1 | NY |
NPI | 1275750291 |
---|---|
Provider Name | Mr. Kevin John Paretti |
First Address | New York, NY 10024-6463 |
Second Address | New York, NY 10024-6463 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |