Individual
MR. ALLAN Z RAYMUNDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 LAKE LN, LAKE GROVE, NY 11755-2463
(163) 142-8705
Mailing address
2 LAKE LN, LAKE GROVE, NY 11755-2463
(163) 142-8705
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
024844-1
NY
Other
Enumeration date
10/02/2008
Last updated
10/02/2008
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