Healthcare Provider Details
I. General information
NPI: 1710591938
Provider Name (Legal Business Name): MOTO PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/04/2020
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 FURMAN PL
EAST NORWICH NY
11732-1313
US
IV. Provider business mailing address
5 FURMAN PL
EAST NORWICH NY
11732-1313
US
V. Phone/Fax
- Phone: 516-972-8897
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
MICHELE
ALIANI
Title or Position: MANAGING PARTNER
Credential: PT
Phone: 516-972-8897