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General NPI Number Information
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NPI Number | 1114733474
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Entity Type | Organization
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Legal Business Name | ABANTE PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 5034 69TH ST
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City | WOODSIDE
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State | NY
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Zip | 11377-7541
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Country | US
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Telephone | 718-606-0366
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Fax |
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Provider Business Mailing Address
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Address Line | 9430 54TH AVE
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City | ELMHURST
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State | NY
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Zip | 11373-4614
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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 | DPT/PRESIDENT
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Name | DR. RANDELL JACOB ABANTE
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Credential |
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Telephone | 347-462-7486
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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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