Individual
BRYLE CADUNGOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, PTA
Contact information
Practice address
1345 AVENUE OF THE AMERICAS, NEW YORK, NY 10105-0302
(212) 981-1977
Mailing address
742 S HANSON DR, WATSEKA, IL 60970-1789
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
044311
NY
225200000X
Physical Therapy Assistant
012309
NY
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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