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1083328751
JAN KEVYN MAXINO TUPAZ
BRONX, NY
NPI
1083328751
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NY P119294)
Enumeration Date
2023-01-09
Last Update Date
2023-01-09
Business Address
JAN KEVYN MAXINO TUPAZ PT
817 E 180TH ST
BRONX, NY 10460-1305
Phone number: 718-355-9652
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Mailing Address
JAN KEVYN MAXINO TUPAZ PT
349 VALLEY ST FL 3
SOUTH ORANGE, NJ 07079-2857
Phone number: 917-349-6347
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