Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 002172 | NY |
NPI | 1003934621 |
---|---|
Provider Name | Ms. Heather Foster |
First Address | Saint Albans, NY 11412-3829 |
Second Address | New York, NY 10003-9502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/07/2007 |