Individual
MRS. MARICEL LACTAOEN BAETIONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1651 CONEY ISLAND AVE., BROOKLYN, NY 12230
(718) 998-1415
Mailing address
74 EMPIRE BLVD, ISLAND PARK, NY 11558-1228
(646) 220-5686
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
023274-01
NY
Other
Enumeration date
07/07/2010
Last updated
07/07/2010
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