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General NPI Number Information
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NPI Number | 1225431208
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Entity Type | Organization
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Legal Business Name | QUALITY PHYSICAL AND MASSAGE THERAPY PLLC
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 10/03/2014
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Provider Practice Location Address
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Address Line | 261 E 78TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-1216
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Country | US
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Telephone | 646-755-8838
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Fax | 646-755-8859
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Provider Business Mailing Address
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Address Line | PO BOX 587
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City | NEW YORK
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State | NY
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Zip | 10028-0019
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Country | US
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Telephone | 646-755-8838
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Fax | 646-755-8859
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Authorized Official
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Title or Position | CEO
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Name | YEVGENIY SAZONOV
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Credential | MT
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Telephone | 917-207-1529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage 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 | 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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