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General NPI Number Information
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NPI Number | 1093084550
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Entity Type | Organization
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Legal Business Name | 3D REHABILITATION SERVICES, PT PC
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 310 EAST 46 ST SUITE 11-A
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 212-867-5827
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Fax | 212-600-1894
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Provider Business Mailing Address
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Address Line | 310 EAST 46 ST SUITE 11-A
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 212-867-5827
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Fax | 212-600-1894
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Authorized Official
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Title or Position | PRESIDENT-3D REHABILITATION SERVICE
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Name | ROMEO TERRY BUGANTE
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Credential |
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Telephone | 917-656-8459
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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 | 032461-1
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License Number State | NY
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