Provider Demographics
NPI:1578131579
Name:YU TIAMCO, FLOYD ANTON A AMORA (PT)
Entity Type:Individual
Prefix:MR
First Name:FLOYD ANTON A
Middle Name:AMORA
Last Name:YU TIAMCO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W 183RD ST APT 6H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3984
Mailing Address - Country:US
Mailing Address - Phone:646-925-9778
Mailing Address - Fax:
Practice Address - Street 1:BACK TO HEALTH MEDICAL PC
Practice Address - Street 2:1729 EAST 12 STREET
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-676-9866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist