Fresh Pond Physical Therapy Astoria, P.C.
Physical Therapist in Astoria, NY. Organization (NPI-2).
NPI number1477819084
StatusActive
Last updated in NPPESMay 20, 2016
Details
- NPI
- 1477819084
- Entity type
- Organization (NPI-2)
- Legal business name
- Fresh Pond Physical Therapy Astoria, P.C.
- Organization subpart
- No
- Enumeration date
- Apr 9, 2012
- Last updated
- May 20, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 015401-1 | NY | Yes |
Practice location
4618 BroadwayAstoria, NY 11103-1628
Phone 718-274-4200 · Fax 718-559-6784
Mailing address
6805 Fresh Pond RdRidgewood, NY 11385-5200
Phone 718-456-2545 · Fax 718-559-6784
Authorized official
Liza Tan
Ceo
7184562543
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