Individual
MR. PROSPERO A TAYCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
113 WOODMERE ST, RARITAN, NJ 08869-1636
(908) 707-9079
Mailing address
113 WOODMERE ST, RARITAN, NJ 08869-1636
(908) 707-9079
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA00587900
NJ
314000000X
Skilled Nursing Facility
Primary
40QA00587900
NJ
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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