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General NPI Number Information
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NPI Number | 1245881457
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Entity Type | Organization
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Legal Business Name | DYNAMISM PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 09/28/2019
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 6241 WOODHAVEN BLVD
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City | REGO PARK
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State | NY
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Zip | 11374-3731
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Country | US
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Telephone | 929-607-3271
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Fax | 929-607-3267
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Provider Business Mailing Address
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Address Line | 245 WOODFIELD RD
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-2528
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Country | US
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Telephone | 908-922-5762
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Fax | 515-565-0929
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Authorized Official
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Title or Position | OWNER/CEO/PT
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Name | DR. NINO POMPEYO ROCCO ALTAMIRANO BORJA
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Credential | PT, DPT
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Telephone | 908-922-5762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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