Individual
ASAD EMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 E GENESEE ST, BALDWINSVILLE, NY 13027-2534
(315) 635-5000
Mailing address
15 E GENESEE ST, BALDWINSVILLE, NY 13027-2534
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
050699
NY
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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