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General NPI Number Information
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NPI Number | 1265091987
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Entity Type | Organization
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Legal Business Name | FIRST STEP FORWARD PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 306 NASSAU BLVD
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City | GARDEN CITY
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State | NY
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Zip | 11530-5314
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Country | US
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Telephone | 516-208-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 306 NASSAU BLVD
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City | GARDEN CITY
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State | NY
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Zip | 11530-5314
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Country | US
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Telephone | 516-208-2100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY EAPEN
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Credential |
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Telephone | 845-494-4440
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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