Individual
MR. JACEK RADOMSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
7533 113TH ST, APT 2 F, FOREST HILLS, NY 11375-7450
(347) 668-3654
Mailing address
7533 113TH ST, APT 2 F, FOREST HILLS, NY 11375-7450
(347) 668-3654
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
004880-1
NY
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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