Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 027887 | NY |
NPI | 1003018722 |
---|---|
Provider Name | Richard Escano |
First Address | Middletown, NY 10941-4028 |
Second Address | Middletown, NY 10941-7001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 18/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02937415 | (05) | NY |