Individual
AILEEN JOY MARAVILLA LAGUNILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
122 E 23RD ST, NEW YORK, NY 10010-4516
(212) 677-7400
(212) 529-2071
Mailing address
2113 SALISBURY PARK DR, WESTBURY, NY 11590-6313
(516) 312-6474
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
012688-1
NY
Other
Enumeration date
05/09/2006
Last updated
07/08/2007
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