Healthcare Provider Details

I. General information

NPI: 1669087300
Provider Name (Legal Business Name): FYSIOMOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 E 86TH ST
NEW YORK NY
10028-2175
US

IV. Provider business mailing address

157 E 86TH ST
NEW YORK NY
10028-2175
US

V. Phone/Fax

Practice location:
  • Phone: 212-831-3315
  • Fax:
Mailing address:
  • Phone: 212-831-3315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JEMELIE DELA CRUZ
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT, CKTP
Phone: 212-831-3315