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General NPI Number Information
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NPI Number | 1356662423
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY SPECIALISTS OF NEW YORK, PLLC
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 870 WESLEY ST
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1432
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Country | US
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Telephone | 516-223-8286
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Fax | 516-223-8286
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Provider Business Mailing Address
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Address Line | 870 WESLEY ST
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1432
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Country | US
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Telephone | 516-223-8286
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Fax | 516-223-8286
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Authorized Official
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Title or Position | MEMBER/ORGANIZER
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Name | CATHERINE LACSAMANA RUIZ
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Credential | PHYSICAL THERAPIST
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Telephone | 516-223-8286
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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 | 020116
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License Number State | NY
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