Individual
CHARMAINE TARCA GERONIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2918 AVENUE M, BROOKLYN, NY 11210-4617
(718) 252-0625
Mailing address
2918 AVENUE M, BROOKLYN, NY 11210-4617
(718) 252-0625
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
041826-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N0119036225
DRIVER'S LICENSE
—
Enumeration date
01/25/2023
Last updated
01/25/2023
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