Individual
RICKY JUAN BISCOCHO MACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
137 BUCKINGHAM PL, LYNBROOK, NY 11563-1954
(917) 420-0108
Mailing address
137 BUCKINGHAM PLACE, LYNBROOK, NY 11563
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
008925
NY
Other
Enumeration date
10/01/2013
Last updated
10/01/2013
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