Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 013729 | NY |
NPI | 1003212408 |
---|---|
Provider Name | Stella Flemister |
First Address | White Plains, NY 10604-2909 |
Second Address | White Plains, NY 10604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2014 |
Last Update Date | 12/11/2014 |