Individual
ANDREW JOSEPH GAETANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS, CSCS
Contact information
Practice address
7 HEMPHILL PL STE 130, MALTA, NY 12020-4482
(518) 577-7106
Mailing address
19 CANTERBURY WOODS ST, QUEENSBURY, NY 12804-1416
(518) 577-7106
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
033577-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01061964
RR MEDICARE
NY
Enumeration date
12/09/2009
Last updated
07/20/2013
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