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General NPI Number Information
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NPI Number | 1154043974
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Entity Type | Organization
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Legal Business Name | YAHALOMIM SHELANU
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 856 W BROADWAY
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City | WOODMERE
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State | NY
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Zip | 11598-2531
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Country | US
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Telephone | 516-426-6925
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Fax |
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Provider Business Mailing Address
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Address Line | 856 W BROADWAY
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City | WOODMERE
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State | NY
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Zip | 11598-2531
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Country | US
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Telephone | 516-426-6925
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANCINE DIAMOND
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Credential |
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Telephone | 516-426-6925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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