Individual
MRS. TANYA M. NEILSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
560 UNION BLVD, WEST ISLIP, NY 11795-3105
(631) 376-4109
Mailing address
1007 OLD MEDFORD AVE, FARMINGVILLE, NY 11738-2829
(631) 236-5784
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
023990-1
NY
Other
Enumeration date
01/31/2007
Last updated
12/01/2016
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