Individual
BONITA SHADANELLE BAYLON LIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT, PT
Contact information
Practice address
6860 AUSTIN ST STE 307, FOREST HILLS, NY 11375-4223
(718) 880-1716
(718) 880-1322
Mailing address
3723 63RD ST, WOODSIDE, NY 11377-2625
(516) 912-5109
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
045638
NY
Other
Enumeration date
03/10/2022
Last updated
03/10/2022
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