MR. Russell Taveras, PT

NPI #1669587465 in Patchogue, New York

Provider Information

NPI Number: 1669587465
Entity Type: Individual
Name: MR. Russell Taveras, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Aug 20, 2006
Last Updated: Mar 7, 2012

Practice Location

Address: 79 E MAIN ST
City: Patchogue
State: New York
ZIP Code: 11772-3101
Phone: (631) 289-0088

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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