Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 004591 | CT |
Y | 2251N0400X | Physical Therapist - Neurology | 004591 | CT |
NPI | 1063636835 |
---|---|
Provider Name | Mrs. Elizabeth Guia Klumac |
First Address | Stamford, CT 06902-7510 |
Second Address | Stamford, CT 06902-7510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 31/12/2012 |