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General NPI Number Information
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NPI Number | 1225180888
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Entity Type | Organization
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Legal Business Name | JOHN TAROS & ALLEN BISTRONG PTR
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 06/15/2008
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Provider Practice Location Address
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Address Line | 142 JORALEMON STREET SUITE 11A
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City | BROOKLYN
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State | NY
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Zip | 11201-4709
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Country | US
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Telephone | 718-875-3167
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Fax | 718-834-0242
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Provider Business Mailing Address
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Address Line | 142 JORALEMON STREET SUITE 11A
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City | BROOKLYN
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State | NY
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Zip | 11201-4709
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Country | US
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Telephone | 718-875-3167
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Fax | 718-834-0242
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | MR. ALLEN LOUIS BISTRONG
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Credential | PT
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Telephone | 718-875-3167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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