Individual
ARLENE BAUTISTA VICENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
13329 41ST RD, #1A, FLUSHING, NY 11355-3670
(718) 939-4166
Mailing address
PO BOX 520112, FLUSHING, NY 11352-0112
(718) 886-8180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022597
NY
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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