Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 003828-1 | NY |
NPI | 1093031403 |
---|---|
Provider Name | Mrs. Sue Ann Kayne |
First Address | Baldwinsville, NY 13027-9319 |
Second Address | East Syracuse, NY 13057-9333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2010 |
Last Update Date | 09/04/2010 |