Individual
IVERSON PATRICK DE VERA CASONGSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
700 NEW YORK AVE, HUNTINGTON, NY 11743-4264
(631) 350-9288
Mailing address
49 GEORGIA ST, EAST NORTHPORT, NY 11731-2232
(934) 500-4299
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
014717-01
NY
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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