Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 036691 | NY |
NPI | 1003156662 |
---|---|
Provider Name | Ms. Shirley Ann Coffey |
First Address | Brooklyn, NY 11209-1805 |
Second Address | Brooklyn, NY 11220-4916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2013 |
Last Update Date | 20/03/2014 |