Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 022974 | NY |
NPI | 1053677724 |
---|---|
Provider Name | Norbert Jack Ryglewicz |
First Address | Syosset, NY 11791-3909 |
Second Address | Huntington, NY 11743-2980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2012 |
Last Update Date | 07/04/2012 |