Individual
BIANCA RAE WAFFENSCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-7059
Mailing address
87 BURROWS LN, BLAUVELT, NY 10913-1305
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
045376
NY
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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