Individual
MYRIAM PRUDHOMME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2220 GOODWIN RD, ELMONT, NY 11003-2816
(718) 377-5000
Mailing address
2220 GOODWIN RD, ELMONT, NY 11003-2816
(718) 377-5000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
013034
NY
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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