Individual
AYA DOMINIQUE LAUAGUE TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5311 90TH ST., APT 3D, ELMHURST, NY 11373
(508) 402-0649
Mailing address
5311 90TH ST., APT 3D, ELMHURST, NY 11373
(508) 402-0649
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
051447-01
NY
Other
Enumeration date
03/12/2026
Last updated
03/12/2026
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