Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 059980 | NY |
N | 2251N0400X | Physical Therapist - Neurology | 059980 | NY |
N | 2251P0200X | Physical Therapist - Pediatrics | 059980 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 059980 | NY |
NPI | 1033371737 |
---|---|
Provider Name | Yisroel Meir Pupko |
First Address | Brooklyn, NY 11210-5132 |
Second Address | Brooklyn, NY 11210-5132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2008 |
Last Update Date | 25/06/2008 |