Individual
JAN KEVYN MAXINO TUPAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
799 MORRIS PARK AVE, BRONX, NY 10462-3604
(718) 684-6300
Mailing address
349 VALLEY ST FL 3, SOUTH ORANGE, NJ 07079-2857
(917) 349-6347
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
014731-01
NY
Other
Enumeration date
01/09/2023
Last updated
10/06/2025
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