Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 003744-1 | NY |
N | 2251P0200X | Physical Therapist - Pediatrics | 003744-1 | NY |
NPI | 1346485083 |
---|---|
Provider Name | Mrs. Christine Eckert Domes |
First Address | Oneida, NY 13421-7024 |
Second Address | Oneida, NY 13421-7024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2008 |
Last Update Date | 09/12/2008 |