Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 019075-1 | NY |
NPI | 1083744874 |
---|---|
Provider Name | Mr. Paul E Palestis |
First Address | Ardsley, NY 10502-1118 |
Second Address | New York, NY 10019-5214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 21/09/2017 |