Individual
BERNADETTE AUDIENCIA HATAMOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 E BROADWAY, NEW YORK, NY 10002
(212) 796-2880
Mailing address
746 50TH ST, APT 1, BROOKLYN, NY 11220
(347) 265-2157
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
039894
NY
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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