Individual
CARISSA PIASIDAD BAYNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 W TORRANCE AVE APT 4, PONTIAC, IL 61764-2761
(646) 858-8334
Mailing address
405 W TORRANCE AVE APT 4, PONTIAC, IL 61764-2761
(646) 858-8334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.023332
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3031400004
CIGNA PPO
—
Enumeration date
04/05/2022
Last updated
04/06/2022
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