Individual
ANTHONY MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2133 RALPH AVE, BROOKLYN, NY 11234-5405
(718) 451-1400
(718) 451-2797
Mailing address
31 NEW DORP LN, STATEN ISLAND, NY 10306-2351
(718) 370-3500
(718) 979-5236
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
008711
NY
Other
Enumeration date
01/28/2013
Last updated
01/28/2013
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