Individual
AGNES KEZIA MONTEALTO MALLARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2579 OCEAN AVE, BROOKLYN, NY 11229-4552
(929) 736-7517
Mailing address
E 22ND, 2174, BROOKLYN, NY 11229
(929) 736-7517
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
050035
NY
Other
Enumeration date
03/14/2024
Last updated
03/28/2024
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