Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 022651 | NY |
N | 2251E1200X | Ergonomics | 022651 | NY |
N | 225XE1200X | Ergonomics | 022651 | NY |
N | 2251S0007X | Physical Therapist - Sports | 022651 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 022651 | NY |
NPI | 1609083211 |
---|---|
Provider Name | Mrs. Mehrbanoo Mehrrostami |
First Address | Bernardsville, NJ 07924-2007 |
Second Address | Bernardsville, NJ 07924-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 11/05/2016 |