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Individual

MARK BOODRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
138 5TH AVE FL 2, NEW YORK, NY 10011-4367
(646) 490-4002
Mailing address
138 5TH AVE FL 2, NEW YORK, NY 10011-4367
(646) 490-4002

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary

Other

Enumeration date
09/27/2024
Last updated
09/27/2024
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