Individual
MR. IVAN SANTOS GARAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
123 W 79TH ST FL 4, NEW YORK, NY 10024-6480
(646) 765-5454
Mailing address
22 ENGLE ST APT 13, ENGLEWOOD, NJ 07631-2923
(201) 541-1978
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
008700
NY
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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