Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 015593-1 | NY |
N | 2251G0304X | Physical Therapist - Geriatrics | 015593-1 | NY |
NPI | 1225360266 |
---|---|
Provider Name | Sabita Aderhold |
First Address | Horseheads, NY 14845-1577 |
Second Address | Horseheads, NY 14845-1577 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2010 |
Last Update Date | 01/02/2010 |