Individual
MR. MAXIMIANO RALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9466
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9466
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
66003951
NY
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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