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Contact Information

CARLY GRAHAM
212 AMBER BEACH ROAD
MARIETTA, NY13310
 Phone: 315-729-9056
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for CARLY GRAHAM · (Female)

NPI # 1356706287
Status Active
Credentials
Entity Individual
Enumeration date 12/18/2015
Last updated 02/04/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 40QA01649600
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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