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1720556392
KEVIN E BALTAZAR
BROOKLYN, NY
NPI
1720556392
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NY 040153)
Enumeration Date
2018-11-12
Last Update Date
2018-11-12
Business Address
Mr. KEVIN E BALTAZAR RPT
3907 4TH AVE
BROOKLYN, NY 11232-2901
Phone number: 347-457-3012
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Mailing Address
Mr. KEVIN E BALTAZAR RPT
6120 WOODSIDE AVE APT 2V
WOODSIDE, NY 11377-3522
Phone number: 917-832-3782
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