Organization · NPI-2

180physiotherapy Pt PLLC

Physical Therapist · Forest Hills, NY

NPI number1770142408
StatusActive
Last updated in NPPESJun 6, 2019

Details

NPI
1770142408
Entity type
Organization (NPI-2)
Legal business name
180physiotherapy Pt PLLC
Organization subpart
No
Enumeration date
Jun 6, 2019
Last updated
Jun 6, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist––Yes

Practice location

6723 Dartmouth St Apt 3
Forest Hills, NY 11375-4052

Phone 347-599-6099

Mailing address

6723 Dartmouth St Apt 3
Forest Hills, NY 11375-4052

Phone 347-599-6099

Authorized official

Boris Avezov
Pt/Owner
3475996099

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