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General NPI Number Information
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NPI Number | 1184094294
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Entity Type | Organization
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Legal Business Name | AGK PHYSICAL THERAPY AND ACUPUNCTURE PLLC
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 80 BROAD ST STE 1401
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City | NEW YORK
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State | NY
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Zip | 10004-2209
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Country | US
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Telephone | 347-277-3252
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Fax | 646-861-2869
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Provider Business Mailing Address
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Address Line | 80 BROAD ST STE 1401
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City | NEW YORK
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State | NY
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Zip | 10004-2209
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Country | US
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Telephone | 347-277-3252
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Fax | 646-861-2869
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARINA KOTLYARSKY
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Credential |
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Telephone | 347-277-3252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 003713
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 026795
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License Number State | NY
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