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General NPI Number Information
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NPI Number | 1154019081
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Entity Type | Organization
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Legal Business Name | BETIKU & HERNANDEZ PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 30 EHRBAR AVE APT 403
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City | MOUNT VERNON
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State | NY
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Zip | 10552-3674
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Country | US
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Telephone | 201-788-6290
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Fax |
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Provider Business Mailing Address
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Address Line | 30 EHRBAR AVE APT 403
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City | MOUNT VERNON
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State | NY
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Zip | 10552-3674
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Country | US
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Telephone | 201-788-6290
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST OWNER
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Name | ADEFEMI A BETIKU
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Credential | DPT
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Telephone | 201-788-6290
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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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