Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 95 Mansion Ave, Si, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225261365 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 021164 (New York) | Primary |
Mailing Address | Practice Location Address |
---|---|
95 Mansion Ave, Si, NY 10308 Ph: (718) 568-4148 | 95 Mansion Ave, Si, NY 10308 Ph: (718) 568-4148 |