Individual
HIDEYUKI OKUWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
6 PENNYFIELD AVE, ATHLETICS, BRONX, NY 10465-4127
(718) 409-7240
Mailing address
286 GRAFF AVE, APT 1, BRONX, NY 10465-3266
(713) 899-9897
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4654
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090702220
BOC
TX
Enumeration date
06/28/2016
Last updated
10/30/2016
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