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General NPI Number Information
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NPI Number | 1205269933
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Entity Type | Organization
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Legal Business Name | M & M OT & PT REHAB PLLC
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Dates
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Enumeration Date | 08/16/2013
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 8647 1646TH ST
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City | JAMAICA
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State | NY
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Zip | 11432-3450
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Country | US
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Telephone | 718-658-2448
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Fax | 718-658-2449
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Provider Business Mailing Address
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Address Line | 8647 1646TH ST
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone | 718-658-2448
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Fax | 718-658-2449
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Authorized Official
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Title or Position | OWNER
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Name | MARIE A.M. MONTLOUIS
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Credential | OT
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Telephone | 718-658-2448
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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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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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