Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 041169 | NY |
NPI | 1073033957 |
---|---|
Provider Name | Namrata Deepesh Agarwal |
First Address | Jersey City, NJ 07310-2040 |
Second Address | Flushing, NY 11368-4018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2017 |
Last Update Date | 22/06/2017 |