Doctor Name: | WENDY BETH PRIVES-BOE |
NPI Number: | 1033446505 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 019078-1 |
Business Practice Address: | 1200 King St Rye Brook, NY - 105737000 |
Business Phone Number: | 9178647706 |
Business Fax Number: | |
Mailing Address: | 206 Mclain St, BEDFORD CORNERS |
State: | NY |
Postal Code: | 105494931 |
Phone Number: | 9142447264 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2009 |
NPI Last Update Date: | 11/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320700000X |
License Number: | 019078-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |