Individual
MS. MARY CANAUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
169 CANTERBURY ROAD, FORT MONTGOMERY, NY 10922
(845) 222-8310
Mailing address
PO BOX 329, FORT MONTGOMERY, NY 10922-0329
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000796-1
NY
Other
Enumeration date
08/17/2007
Last updated
08/17/2007
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