Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 6890 | NY |
NPI | 1093969339 |
---|---|
Provider Name | Mr. Robert Paskoff |
First Address | Lynbrook, NY 11563-2501 |
Second Address | Lynbrook, NY 11563-2501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2008 |
Last Update Date | 13/11/2008 |