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General NPI Number Information
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NPI Number | 1063054567
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Entity Type | Organization
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Legal Business Name | 38 W PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 156 WILLIAM ST RM 801
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City | NEW YORK
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State | NY
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Zip | 10038-0083
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Country | US
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Telephone | 848-565-4819
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Fax | 646-559-1358
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Provider Business Mailing Address
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Address Line | 156 WILLIAM ST RM 801
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City | NEW YORK
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State | NY
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Zip | 10038-0083
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Country | US
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Telephone | 848-565-4819
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Fax | 646-559-1358
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Authorized Official
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Title or Position | OWNER
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Name | MISS KRISTINE MAY PARCON
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Credential | D.P.T
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Telephone | 848-565-4819
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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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