Individual
CHESTER EVIDENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3400 CANNON PL, BRONX, NY 10463-4302
(240) 408-9047
Mailing address
2810 JACKSON AVE APT 17S, LONG ISLAND CITY, NY 11101-3143
(240) 408-9047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
041801
NY
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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