Healthcare Provider Details

I. General information

NPI: 1235174228
Provider Name (Legal Business Name): H&D PHYSICAL THERAPY & OCCUPATIONAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 2ND AVE
NEW YORK NY
10017-4503
US

IV. Provider business mailing address

815 2ND AVE
NEW YORK NY
10017-4503
US

V. Phone/Fax

Practice location:
  • Phone: 212-499-0848
  • Fax: 212-753-0713
Mailing address:
  • Phone: 212-499-0876
  • Fax: 212-953-1353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SVETLANA SHAGABAYEVA
Title or Position: BC ACCOUTNS MANAGER
Credential:
Phone: 212-499-0876