Individual
ELY BOY RACOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
711 32ND STREET, UNION CITY, NJ 07087
(201) 866-0600
(201) 866-8340
Mailing address
711 32ND STREET, UNION CITY, NJ 07087
(201) 866-0600
(201) 866-8340
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01154400
NJ
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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