Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 001916 | NY |
NPI | 1013554781 |
---|---|
Provider Name | Shonda Saunders |
First Address | Jersey City, NJ 07305-3510 |
Second Address | Jersey City, NJ 07305-3510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2019 |
Last Update Date | 02/12/2019 |