Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1265044887 |
---|---|
Provider Name | Samantha M Stangarone |
First Address | Brooklyn, NY 11223-3533 |
Second Address | Brooklyn, NY 11228-2038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2020 |
Last Update Date | 17/08/2020 |