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General NPI Number Information
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NPI Number | 1275607996
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Entity Type | Individual
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Provider Name | RACHEL MARGARET GAMBINO PT DPT
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1228 WANTAGH AVENUE SUITE 104 SOUTH SHORE PEDIATRIC PHYSICAL THERAPY LLP
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City | WANTAGH
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State | NY
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Zip | 11793
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Country | US
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Telephone | 516-785-5257
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Fax | 516-785-5154
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Provider Business Mailing Address
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Address Line | 131 FIRST STREET RACHEL M GAMBINO
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City | HOLBROOK
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State | NY
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Zip | 11741
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Country | US
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Telephone | 516-984-2615
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 0167501
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License Number State | NY
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