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General NPI Number Information
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NPI Number | 1013738756
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Entity Type | Organization
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Legal Business Name | KO PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 119 W 23RD ST STE 804
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City | NEW YORK
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State | NY
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Zip | 10011-6344
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Country | US
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Telephone | 516-238-0726
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Fax |
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Provider Business Mailing Address
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Address Line | 21 SOULARD ST APT 1
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City | HARRISON
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State | NY
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Zip | 10528-3780
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Country | US
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Telephone | 516-238-0726
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KERRY OJEDA
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Credential | DPT
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Telephone | 516-238-0726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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