Individual
AYAM TIRONA DELEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
8798 193RD ST, HOLLIS, NY 11423-1439
(718) 291-4703
(914) 739-3140
Mailing address
637 CARDINAL RD, CORTLANDT MANOR, NY 10567-5201
(845) 282-1022
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
0229731
NY
2251X0800X
Orthopedic Physical Therapist
Primary
0229731
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11934054
CAQH
—
Enumeration date
09/21/2005
Last updated
02/08/2012
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