Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 016194-1 | NY |
NPI | 1003065970 |
---|---|
Provider Name | Ms. Teresa Shum-Leung |
First Address | Bellerose, NY 11426-2024 |
Second Address | Bellerose, NY 11426-2024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2008 |
Last Update Date | 15/09/2008 |