Individual
MR. AMORSOLO CENON LAURETA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
6440 58TH RD, MASPETH, NY 11378-2806
(718) 316-7072
Mailing address
6440 58TH RD, MASPETH, NY 11378-2806
(718) 316-7072
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
019985-1
NY
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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