Individual
KIMBERLY J MAYKISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
19 NORTH MAIN STREET, SHERBURNE, NY 13460
(607) 674-6262
(607) 674-6263
Mailing address
19 NORTH MAIN STREET, SHERBURNE, NY 13460
(607) 674-6262
(607) 674-6263
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
025420-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629096805
ACT PHYSICAL THERAPY NPI
NY
01
—
205143326
ACT PT TAX ID
NY
Enumeration date
11/09/2006
Last updated
09/10/2014
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