Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 006090-1 | NY |
NPI | 1063667285 |
---|---|
Provider Name | Ms. Anastasia M. Dilieto |
First Address | New York, NY 10013-2786 |
Second Address | New York, NY 10013-2786 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2008 |
Last Update Date | 02/12/2008 |