Individual
BRYAN ILA QUEDDENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
741 E 233RD ST, BRONX, NY 10466-3201
(718) 405-0205
(718) 405-1628
Mailing address
174 GRAND ST, WHITE PLAINS, NY 10601-4803
(914) 328-8077
(914) 328-6083
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
029825
NY
Other
Enumeration date
01/08/2008
Last updated
05/05/2009
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