Individual
THEODORE CHUKWU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
10017 23RD AVE, EAST ELMHURST, NY 11369-1305
(718) 205-8100
Mailing address
9817 HORACE HARDING EXPY APT 1K, CORONA, NY 11368-4224
(718) 685-8432
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
007802
NY
Other
Enumeration date
10/31/2019
Last updated
10/31/2019
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