Healthcare Provider Details

I. General information

NPI: 1073969754
Provider Name (Legal Business Name): 7TH AVE MS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6022 7TH AVE
BROOKLYN NY
11220-4105
US

IV. Provider business mailing address

6022 7TH AVE
BROOKLYN NY
11220-4105
US

V. Phone/Fax

Practice location:
  • Phone: 718-439-1381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: MR. GUI XIANG YUE
Title or Position: OWNER
Credential:
Phone: 718-439-1381