Most Relevant Information
Provider Data
| NPI Number: | 1003387192 |
| Provider Name: | TAI LUONG LA PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 010442 |
Most Important Dates
| Enumeration Date: | 12/16/2018 |
| Last Updated: | 12/16/2018 |
Provider Practice Location
6010 BAY PKWY
BROOKLYN
NY
112046079
Practice Location Phone/Fax
| Phone: | 7182838962 |
| Fax: |
Provider Mailing Location
6010 BAY PARKWAY
BROOKLYN
NY
11214
Provider Mailing Phone/Fax
| Phone: | 7182838962 |
| Fax: |