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General NPI Number Information
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NPI Number | 1073703070
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Entity Type | Organization
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Legal Business Name | IMSR INC
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2367 WESTCHESTER AVE
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City | BRONX
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State | NY
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Zip | 10462-5007
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Country | US
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Telephone | 718-597-2900
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Fax | 718-597-2902
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Provider Business Mailing Address
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Address Line | 2367 WESTCHESTER AVE
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City | BRONX
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State | NY
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Zip | 10462-5007
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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 | OWNER
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Name | ISLAM M SHERIF
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Credential | PHYSICAL THERAPIST
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Telephone | 917-686-0497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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