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General NPI Number Information
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NPI Number | 1306503750
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Entity Type | Organization
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Legal Business Name | COMPANION PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 11/19/2021
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 65 FORDHAM AVE
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City | HICKSVILLE
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State | NY
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Zip | 11801-5634
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Country | US
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Telephone | 516-469-9973
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Fax |
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Provider Business Mailing Address
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Address Line | 65 FORDHAM AVE
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City | HICKSVILLE
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State | NY
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Zip | 11801-5634
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Country | US
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Telephone | 516-469-9973
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MAGED GABALLA
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Credential | PT
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Telephone | 516-469-9973
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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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