Individual
MR. ANTONIO ABAN LAXA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
36 MALDON ST, MALVERNE, NY 11565-1515
(917) 974-6485
(516) 837-9486
Mailing address
36 MALDON ST, MALVERNE, NY 11565-1515
(917) 974-6485
(516) 837-9486
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
P.T. 018945-1
NY
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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