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Organization
MICHAEL J BANOME
Active
Organization
MICHAEL J BANOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOSEPH BANOME PT, DPT (PHYSICAL THERAPIST)
(347) 804-4956
Entity
Organization
Contact information
Practice address
2812 201ST ST, BAYSIDE, NY 11360-2321
(347) 804-4956
Mailing address
2812 201ST ST, BAYSIDE, NY 11360-2321
(347) 804-4956
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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