Individual
MS. RANDI SUSAN BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
565 RUGBY RD, BROOKLYN, NY 11230-1501
(718) 703-7737
Mailing address
565 RUGBY RD, BROOKLYN, NY 11230-1501
(718) 703-7737
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
015246-1
NY
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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