Individual
MR. CHRISTIAN BANCAYA OLIVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
23 LACE LN, WESTBURY, NY 11590-6314
(646) 431-5900
Mailing address
23 LACE LN, WESTBURY, NY 11590-6314
(516) 385-8396
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
021803
NY
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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