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General NPI Number Information
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NPI Number | 1023386091
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Entity Type | Organization
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Legal Business Name | ANDORA PHYSICAL THERAPY SERVICES
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 350 WARWICK AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10553-1814
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Country | US
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Telephone | 917-642-5169
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Fax |
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Provider Business Mailing Address
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Address Line | 350 WARWICK AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10553-1814
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Country | US
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Telephone | 917-642-5169
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Fax |
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Authorized Official
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Title or Position | OWNER/PT
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Name | MS. AMADIKA BIENTA HOSPEDALES
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Credential | MSPT
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Telephone | 917-642-5169
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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 | 024372-1
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License Number State | NY
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