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General NPI Number Information
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NPI Number | 1306139464
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Entity Type | Organization
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Legal Business Name | TOTAL PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 1484 DEER PARK AVE
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City | NORTH BABYLON
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State | NY
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Zip | 11703-1208
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Country | US
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Telephone | 631-940-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1484 DEER PARK AVE
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City | NORTH BABYLON
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State | NY
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Zip | 11703-1208
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ESSAM S MOSTAFA
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Credential | P.T.
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Telephone | 631-940-9000
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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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