Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 0065921 | NY |
NPI | 1023130531 |
---|---|
Provider Name | Roschelle Fiona Mcbean |
First Address | Brooklyn, NY 11212-1470 |
Second Address | Rockaway Park, NY 11694-2744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 08/07/2007 |