Individual
JOHN MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3428 10TH ST, LONG ISLAND CITY, NY 11106-5182
(347) 684-8166
Mailing address
3428 10TH ST, LONG ISLAND CITY, NY 11106-5182
(347) 684-8166
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
009340-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280506410
STATE ID
NY
Enumeration date
05/17/2018
Last updated
06/16/2018
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