Individual
CAMILO MARAVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 POST RD, SCARSDALE, NY 10583-5063
(914) 722-6540
Mailing address
4719 156TH ST, FLUSHING, NY 11355-2341
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
016721
NY
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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