Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 005193-1 | NY |
NPI | 1063729440 |
---|---|
Provider Name | Mrs. Lillian A Gabriel |
First Address | Manhasset, NY 11030-1829 |
Second Address | Manhasset, NY 11030-1829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2010 |
Last Update Date | 08/09/2010 |