Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 019168-1 | NY |
NPI | 1063722841 |
---|---|
Provider Name | Mrs. Robin Hauser |
First Address | Merrick, NY 11566 |
Second Address | Merrick, NY 11566 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2010 |
Last Update Date | 28/10/2010 |