Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | N/A | NY |
NPI | 1851622625 |
---|---|
Provider Name | Tod T Grapes |
First Address | New York, NY 10025-3248 |
Second Address | New York City, NY 10025-3248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2010 |
Last Update Date | 19/01/2010 |