Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 024132 | NY |
NPI | 1043455124 |
---|---|
Provider Name | Ms. Ruby Rose Uy |
First Address | Long Island City, NY 11101-5259 |
Second Address | Long Island City, NY 11101-5334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2008 |
Last Update Date | 22/03/2012 |