Healthcare Provider Details

I. General information

NPI: 1891332011
Provider Name (Legal Business Name): HANDS-ON PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2019
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 SECURITY BLVD STE 108
BALTIMORE MD
21244-2540
US

IV. Provider business mailing address

3244 31ST ST
ASTORIA NY
11106-2561
US

V. Phone/Fax

Practice location:
  • Phone: 718-707-6970
  • Fax: 718-228-4955
Mailing address:
  • Phone: 718-707-6970
  • Fax: 718-228-4955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DIMITRIOS KOSTOPOULOS
Title or Position: OWNER
Credential:
Phone: 718-707-6970