Healthcare Provider Details

I. General information

NPI: 1831499078
Provider Name (Legal Business Name): LLANDRO ESCARRO LLANDER P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 GRAND ST FL 3
NEW YORK NY
10002-4800
US

IV. Provider business mailing address

465 GRAND ST FL 3
NEW YORK NY
10002-4800
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-1999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number030876
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: