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Individual
MS. DOROTHEA BURGET SOUTHWICK
Active
Individual
MS. DOROTHEA BURGET SOUTHWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0065281
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000405998001
BLUE SHIELD OF NORTHEASTE
NY
01
—
110409700
US DEPT OF LABOR OWCP
—
01
—
141733498
EMPIRE STATE PLAN GROUP
NY
01
—
650005243
RAILROAD MEDICARE
—
01
—
819687
EMPIRE STATE PLAN
NY
01
—
GRP405998002
BLUE SHIELD OF NORTHEASTE
NY
01
—
P01010652
EXCELLUS
NY
01
—
Q66831
EMPIRE BLUE CROSS/EMPIRE
NY
01
—
Q66832
EMPIRE BCBS
NY
Enumeration date
09/30/2005
Last updated
12/01/2016
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