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Individual
HEATHER ROBERTS
Active
Individual
HEATHER ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
014531-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02250402
—
NY
01
—
10096311
CDPHP PROVIDER NUMBER
NY
01
—
603426
MVP PROVIDER NUMBER
NY
01
—
89756
GHI PROVIDER NUMBER
NY
01
—
Q16R71
EMPIRE BC/BS
NY
Enumeration date
07/26/2006
Last updated
10/31/2011
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