Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 002097-1 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | 023345 | NY |
NPI | 1073812194 |
---|---|
Provider Name | Mrs. Karen Ann Flannery-Sheboy |
First Address | Washingtonville, NY 10992-1830 |
Second Address | West Nyack, NY 10994-1025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2011 |
Last Update Date | 03/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122297568 | (05) | NY |