Individual
BRYAN JOSEPH GICANA DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
865 CYPRESS AVE, RIDGEWOOD, NY 11385-4724
(848) 667-0943
(848) 667-0943
Mailing address
5211 79TH ST FL 2, ELMHURST, NY 11373-4112
(848) 667-0943
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
041569
NY
Other
Enumeration date
05/22/2017
Last updated
05/22/2017
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