Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT40QA01151800 | NJ |
NPI | 1205246279 |
---|---|
Provider Name | Socorro Uy |
First Address | Totowa, NJ 07512-2440 |
Second Address | Clifton, NJ 07013-3619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2014 |
Last Update Date | 30/04/2014 |