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General NPI Number Information
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NPI Number | 1063684629
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Entity Type | Organization
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Legal Business Name | PHYSIOFITNESS P.T., P.C.
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 584 BROADWAY SUITE 710
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City | NEW YORK
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State | NY
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Zip | 10012-3229
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Country | US
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Telephone | 212-941-0503
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Fax | 212-941-6195
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Provider Business Mailing Address
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Address Line | 584 BROADWAY SUITE 710
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City | NEW YORK
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State | NY
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Zip | 10012-3229
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Country | US
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Telephone | 212-941-0503
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Fax | 212-941-6195
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. CHRISTOPHER W. DELEHANTY
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Credential | P.T.
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Telephone | 212-941-0503
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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 | 0120881
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License Number State | NY
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