Individual
MARC LOUIE MAGUNDAYAO IBANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 BAYBERRY LN, LEVITTOWN, NY 11756-4001
(929) 238-4710
Mailing address
21 BAYBERRY LN, LEVITTOWN, NY 11756-4001
(929) 238-4710
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012828
NY
Other
Enumeration date
01/01/2024
Last updated
01/04/2024
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