Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 003758-1 | NY |
NPI | 1003908146 |
---|---|
Provider Name | Mrs. Barbara Ann Sipper |
First Address | Chester, NY 10918-2641 |
Second Address | Monticello, NY 12701-7013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |