RUSSELL TAVERAS

PATCHOGUE, NY
NPI1669587465
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: NY  0270991)
Enumeration Date2006-08-20
Last Update Date2012-03-07
Business Address
Mr. RUSSELL TAVERAS PT
79 E MAIN ST
PATCHOGUE, NY 11772-3101
Phone number: 631-289-0088
Mailing Address
Mr. RUSSELL TAVERAS PT
79 E MAIN ST STE I
PATCHOGUE, NY 11772-3101
Phone number: 631-289-0088
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