Individual
EDWIN GITUAYAN LUCENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2444 BEAUMONT AVE, BRONX, NY 10458-6548
(347) 679-7078
Mailing address
2444 BEAUMONT AVE, BRONX, NY 10458-6548
(347) 679-7078
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
013202-02
NY
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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