# MR. PROSPERO A TAYCO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1063734705
- **Gender:** Man
- **Credential:** P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 40QA00587900 | NJ | — |
| 314000000X | Skilled Nursing Facility | 40QA00587900 | NJ | Yes |

## Other

- **Enumeration date:** 02/22/2010
- **Last updated:** 02/22/2010