Individual
SHIRLEY DOCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
57 BRAND DR, HUNTINGTON, NY 11743-4528
(631) 470-2096
Mailing address
57 BRAND DR, HUNTINGTON, NY 11743-4528
(631) 470-2096
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
020718
NY
2251P0200X
Pediatric Physical Therapist
Primary
020718
NY
2251X0800X
Orthopedic Physical Therapist
020718
NY
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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