Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 038737 | NY |
NPI | 1003203670 |
---|---|
Provider Name | Tanya Rattray |
First Address | New York, NY 10038-3101 |
Second Address | New York, NY 10038-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2015 |
Last Update Date | 22/04/2015 |