Photina Faye Penn, Physical Therapist
Physical Therapist in Coram, NY. Individual provider (NPI-1).
NPI number1861661803
StatusActive
Last updated in NPPESFeb 25, 2008
Details
- NPI
- 1861661803
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Photina Faye Penn
- Credential
- Physical Therapist
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 25, 2008
- Last updated
- Feb 25, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 005546-1 | NY | Yes |
Practice location
31 Wintergreen DrCoram, NY 11727-2222
Phone 631-331-1780
Mailing address
31 Wintergreen DrCoram, NY 11727-2222
Phone 631-331-1780
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All 20 Physical Therapist providers in Coram · All 676 providers in Coram
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