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1659737393
MICHAEL BANOME
BAYSIDE, NY
NPI
1659737393
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NY 039757-1)
Additional Taxonomies
225100000X Physical Therapist
Enumeration Date
2016-01-11
Last Update Date
2020-11-13
Business Address
MICHAEL BANOME
2812 201ST ST
BAYSIDE, NY 11360-2321
Phone number: 347-804-4956
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Mailing Address
MICHAEL BANOME
2812 201ST ST
BAYSIDE, NY 11360-2321
Phone number: 347-804-4956
Copy
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