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General NPI Number Information
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NPI Number | 1114042017
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Entity Type | Organization
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Legal Business Name | EXCELLENCE REHAB & PHYSICAL THERAPY,PC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1894 EASTCHESTER RD 1ST FLOOR
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City | BRONX
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State | NY
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Zip | 10461-2328
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Country | US
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Telephone | 718-518-1133
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Fax | 718-518-1244
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Provider Business Mailing Address
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Address Line | 1894 EASTCHESTER RD 1ST FLOOR
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City | BRONX
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State | NY
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Zip | 10461-2328
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Country | US
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Telephone | 718-518-1133
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Fax | 718-518-1244
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOCELYN GLORIA ALONSO RUIZ DE GUZMAN
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Credential | P.T.
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Telephone | 718-518-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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