Individual
COLLIN CARMILLE BUCOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
38 NEWPORT RD APT 3, ISLAND PARK, NY 11558-1013
(646) 750-4313
Mailing address
38 NEWPORT RD APT 3, ISLAND PARK, NY 11558-1013
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
041343
NY
225200000X
Physical Therapy Assistant
013581
NY
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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