Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 005784 | NY |
NPI | 1003314964 |
---|---|
Provider Name | Ms. Susan Carol Lenihan |
First Address | Great Neck, NY 11021-4802 |
Second Address | Great Neck, NY 11021-4802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2018 |
Last Update Date | 28/12/2021 |