Individual
SAM PAGUNTALAN DEPASUPIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
261 EAGLE AVE, NEW MILFORD, NJ 07646-1709
(201) 851-2239
Mailing address
261 EAGLE AVE, NEW MILFORD, NJ 07646-1709
(201) 851-2239
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
009595-1
NY
225200000X
Physical Therapy Assistant
Primary
40QB00308200
NJ
Other
Enumeration date
05/20/2015
Last updated
05/20/2015
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