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Contact Information

CHAMPION PROFESSIONAL SERVICES
93 TALLMADGE TRL
MILLER PLACE, NY11764-2327
 Phone: 631-828-4373
 Fax: 631-828-4373
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for CHAMPION PROFESSIONAL SERVICES · (Female)

NPI # 1487998183
Status Active
Credentials
Entity Individual
Enumeration date 11/19/2012
Last updated 11/19/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 18775
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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