Individual
ANTHONY DERRICO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 SUMMIT STREET, COHOES, NY 12047
(518) 486-9024
Mailing address
20 SUMMIT ST, COHOES, NY 12047-2516
(518) 486-9024
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
003212-1
NY
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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