Individual
MR. BRIANLEE SACARES TACULOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
11126 CORONA AVE, CORONA, NY 11368-4027
(718) 592-6400
Mailing address
263 HANCOCK ST APT 2A, BROOKLYN, NY 11216-2202
(347) 636-6603
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13867
CT
225200000X
Physical Therapy Assistant
011593-01
NY
261QP2000X
Physical Therapy Clinic/Center
043438-01
NY
Other
Enumeration date
02/21/2022
Last updated
02/26/2023
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