Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 006915 | NY |
NPI | 1043459589 |
---|---|
Provider Name | Ms. Gay Randi Rosenberg |
First Address | New York, NY 10024-1336 |
Second Address | New York, NY 10024-1321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2009 |
Last Update Date | 06/02/2009 |