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General NPI Number Information
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NPI Number | 1255439790
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Entity Type | Individual
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Provider Name | LILLY RAWLYK PT
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 201 SOUTH AVE SUITE 501
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City | POUGHKEEPSIE
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State | NY
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Zip | 12601-4812
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Country | US
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Telephone | 845-475-5668
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Fax | 845-473-6048
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Provider Business Mailing Address
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Address Line | 5 ARDEN LN
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City | NEW PALTZ
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State | NY
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Zip | 12561-3501
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Country | US
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Telephone | 845-255-3409
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 008377-0
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License Number State | NY
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