410 Physical Therapy PC
Physical Therapist in Jamaica, NY. Organization (NPI-2).
NPI number1053718957
StatusActive
Last updated in NPPESFeb 19, 2015
Details
- NPI
- 1053718957
- Entity type
- Organization (NPI-2)
- Legal business name
- 410 Physical Therapy PC
- Organization subpart
- No
- Enumeration date
- Nov 21, 2014
- Last updated
- Feb 19, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 024252 | NY | Yes |
Practice location
9050 Parsons Blvd Ste 410Jamaica, NY 11432-6052
Phone 718-687-2474
Mailing address
9050 Parsons Blvd Ste 410Jamaica, NY 11432-6052
Phone 718-687-2474
Authorized official
Alvin Tupaz
Owner
9177571141
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