Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 8399 | NY |
NPI | 1083717987 |
---|---|
Provider Name | Mrs. Valerie Beth Harris |
First Address | Staten Island, NY 10314 |
Second Address | Staten Island, NY 10314-4114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |