Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 8125 | NY |
NPI | 1063554160 |
---|---|
Provider Name | Ms. Felice Menchel |
First Address | Long Beach, NY 11561-4644 |
Second Address | Long Beach, NY 11561-4644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |