Individual
MR. EDWARD GERARD DE PEDRO TABUADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1084 LIBERTY AVE, BROOKLYN, NY 11208-2923
(347) 586-0625
Mailing address
1084 LIBERTY AVE, BROOKLYN, NY 11208-2923
(347) 586-0625
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
013214-01
NY
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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