| NPI | 1982990743 |
|---|---|
| Doing Business As | ST JUDE'S PEDIATRIC SERVICES |
| Entity Type | Organization |
| Authorized Contact | KEISHA E JOHN Co President 347-524-0630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 028641) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 016896-1) |
| 235Z00000X Speech-Language Pathologist, (Licence: NY 020555-1) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2011-11-23 |