Individual
MANOJABASINGH RUSSALIAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8003 211TH ST, HOLLIS HILLS, QUEENS VILLAGE, NY 11427-1012
(518) 364-2954
Mailing address
4332 KISSENA BLVD, 1T, FLUSHING, NY 11355-2934
(518) 364-2954
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
038995
NY
2251X0800X
Orthopedic Physical Therapist
Primary
038995
NY
Other
Enumeration date
01/24/2017
Last updated
04/05/2017
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