Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 019162-1 | NY |
NPI | 1104133891 |
---|---|
Provider Name | Mrs. Deborah L. Kochman |
First Address | Forest Hills, NY 11375-6723 |
Second Address | Forest Hills, NY 11375-6723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2010 |
Last Update Date | 02/09/2010 |