Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 37406 | NY |
NPI | 1003205311 |
---|---|
Provider Name | Nepthalie Borlaza |
First Address | Fresh Meadows, NY 11366-1250 |
Second Address | Fresh Meadows, NY 11366-1250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2015 |
Last Update Date | 10/01/2015 |