Individual
RYAN BACLIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
575 8TH AVE FL 6, NEW YORK, NY 10018-3158
(212) 221-1544
Mailing address
17018 76TH AVE, FRESH MEADOWS, NY 11366-1319
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012676-01
NY
Other
Enumeration date
04/25/2021
Last updated
04/25/2021
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