MICHAEL BANOME

BAYSIDE, NY
NPI1659737393
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: NY  039757-1)
Additional Taxonomies225100000X Physical Therapist
Enumeration Date2016-01-11
Last Update Date2020-11-13
Business Address
MICHAEL BANOME
2812 201ST ST
BAYSIDE, NY 11360-2321
Phone number: 347-804-4956
Mailing Address
MICHAEL BANOME
2812 201ST ST
BAYSIDE, NY 11360-2321
Phone number: 347-804-4956
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