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Individual
MR. EDSEL LAWRENCE ROXAS AVELINO
Active
Individual
MR. EDSEL LAWRENCE ROXAS AVELINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
017862-1
NY
225100000X
Physical Therapist
40QA00931100
NJ
Other
Enumeration date
07/27/2006
Last updated
03/30/2012
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