Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 012187-1 | NY |
NPI | 1063781219 |
---|---|
Provider Name | Mrs. Andrea Silvana Escos |
First Address | Rochester, NY 14610-1007 |
Second Address | Rochester, NY 14605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2011 |
Last Update Date | 16/12/2011 |