Individual
PETER STEVEN PANAGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5026 OCEANIA ST, BAYSIDE, NY 11364-1123
(718) 598-0548
Mailing address
5026 OCEANIA ST, BAYSIDE, NY 11364-1123
(718) 598-0548
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
004033
NY
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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