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General NPI Number Information
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NPI Number | 1306263363
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Entity Type | Organization
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Legal Business Name | BRONX PHYSICAL THERAPY AND REHABILITATION PLLC
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 984 MORRIS PARK AVE
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City | BRONX
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State | NY
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Zip | 10462-3714
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Country | US
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Telephone | 718-823-7676
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Fax | 718-823-7675
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Provider Business Mailing Address
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Address Line | 984 MORRIS PARK AVE
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City | BRONX
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State | NY
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Zip | 10462-3714
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Country | US
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Telephone | 718-823-7676
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Fax | 718-823-7675
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. SAMUEL IGNACIO
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Credential | PT
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Telephone | 718-823-7676
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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 | 011119
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License Number State | NY
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