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NPI 1275805830

NPI 1275805830 : BODY POWER PHYSICAL THERAPY PC : FREEPORT, NY

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General NPI Number Information
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    NPI Number           |    1275805830
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    Entity Type          |    Organization 
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    Legal Business Name  |    BODY POWER PHYSICAL THERAPY PC 
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Dates
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    Enumeration Date     |    01/29/2012
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    Last Update Date     |    11/14/2013
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Provider Practice Location Address
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    Address Line         |    49 CHURCH ST 
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    City                 |    FREEPORT
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    State                |    NY
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    Zip                  |    11520-3837
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    Country              |    US
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    Telephone            |    516-623-6253
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    Fax                  |    516-623-8450
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Provider Business Mailing Address
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    Address Line         |    49 CHURCH ST 
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    City                 |    FREEPORT
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    State                |    NY
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    Zip                  |    11520-3837
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    Country              |    US
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    Telephone            |    516-623-6253
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    Fax                  |    516-623-8450
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Authorized Official
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    Title or Position    |    CEO/DIRECTOR
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    Name                 |    MR. BABU  MOSES 
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    Credential           |    PT,DSC,ECS,MTC
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    Telephone            |    516-623-6253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    
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    License Number State |    
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