Provider Demographics
NPI:1487479473
Name:ADRIANO, TRAYAN PAYNE (PT)
Entity type:Individual
Prefix:
First Name:TRAYAN PAYNE
Middle Name:
Last Name:ADRIANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3713 59TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2530
Mailing Address - Country:US
Mailing Address - Phone:347-604-1625
Mailing Address - Fax:
Practice Address - Street 1:8411 QUEENS BLVD FL 1
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3098
Practice Address - Country:US
Practice Address - Phone:929-522-0841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty