Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 35371 | NY |
NPI | 1003167651 |
---|---|
Provider Name | Mr. Peter Lipinski |
First Address | East Meadow, NY 11554-3122 |
Second Address | Westbury, NY 11590-5640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2012 |
Last Update Date | 23/09/2012 |