Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 001911-1 | NY |
NPI | 1013260470 |
---|---|
Provider Name | Ruth E. Enriquez |
First Address | New York, NY 10035-1316 |
Second Address | New York, NY 10035-1316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2012 |
Last Update Date | 08/11/2012 |