Individual
MIRA RIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47 KILDARE RD, ISLAND PARK, NY 11558-1025
(646) 203-1557
Mailing address
47 KILDARE RD, ISLAND PARK, NY 11558-1025
(646) 203-1557
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00518401
NY
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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