Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 017598-1 | NY |
NPI | 1104071711 |
---|---|
Provider Name | Robin Hollis |
First Address | New York, NY 10065-6743 |
Second Address | New York, NY 10065-6743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2008 |
Last Update Date | 24/11/2008 |