Healthcare Provider Details

I. General information

NPI: 1023351525
Provider Name (Legal Business Name): PLAY AND GROW PHYSICAL THERAPY AND SPEECH LANGUAGE PATHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 03/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DARROW PLACE SUITE 24E
BRONX NY
10475
US

IV. Provider business mailing address

140 DARROW PL SUITE 24E
BRONX NY
10475-1802
US

V. Phone/Fax

Practice location:
  • Phone: 917-837-9712
  • Fax: 212-477-8164
Mailing address:
  • Phone: 917-837-9712
  • Fax: 212-477-8164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number513282
License Number StateNY

VIII. Authorized Official

Name: MRS. SANDY L. FRANCIS
Title or Position: OWNER
Credential: PT
Phone: 917-837-9712