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General NPI Number Information
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NPI Number | 1013575539
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Entity Type | Organization
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Legal Business Name | TANDEM IN CARE PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 1467 BELLMORE AVE
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-5501
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Country | US
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Telephone | 516-382-7379
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Fax |
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Provider Business Mailing Address
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Address Line | 1467 BELLMORE AVE
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-5501
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | LAXMI DE JESUS
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Credential | PT, DPT
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Telephone | 516-382-7379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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