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General NPI Number Information
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NPI Number | 1376603431
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Entity Type | Organization
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Legal Business Name | PRO-TEK PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 1706 UTOPIA PKWY
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City | WHITESTONE
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State | NY
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Zip | 11357-3320
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Country | US
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Telephone | 718-489-3535
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Fax | 866-217-4437
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Provider Business Mailing Address
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Address Line | 1706 UTOPIA PKWY
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City | WHITESTONE
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State | NY
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Zip | 11357-3320
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Country | US
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Telephone | 718-489-3535
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Fax | 866-217-4437
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. JOSEPH COLLURA
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Credential | P.T.
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Telephone | 718-489-3535
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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 | 022343
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License Number State | NY
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