Individual
GLENN PATRICK KATIGBAC INCIONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1345 AVENUE OF THE AMERICAS, NEW YORK, NY 10105-0302
(212) 981-1977
Mailing address
5124 VAN LOON ST, ELMHURST, NY 11373-4255
(929) 289-3995
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
011961-01
NY
Other
Enumeration date
04/29/2022
Last updated
04/29/2022
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