Individual
BRIAN POREMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 MAVERICK TER, WOODSTOCK, NY 12498-1723
(845) 679-7643
(845) 679-7643
Mailing address
17 MAVERICK TER, WOODSTOCK, NY 12498-1723
(845) 679-7643
(845) 679-7643
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
024821-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225100000X
PHYSICAL THERAPY OUTPATIENT
NY
Enumeration date
03/16/2010
Last updated
03/16/2010
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