Individual
BRYAN BARACALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1000 NORTHERN BLVD, GREAT NECK, NY 11021-5338
(516) 466-9730
Mailing address
800 E GATE BLVD, GARDEN CITY, NY 11530-2105
(516) 745-8070
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
046008
NY
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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