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General NPI Number Information
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NPI Number | 1396156261
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Entity Type | Organization
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Legal Business Name | FIGHT PHYSICAL THERAPY P.C
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Dates
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Enumeration Date | 05/14/2014
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 1 W 30TH ST SUITE 206
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City | NEW YORK
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State | NY
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Zip | 10001-4424
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Country | US
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Telephone | 718-791-9423
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Fax |
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Provider Business Mailing Address
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Address Line | 339 E 88TH ST 4F
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City | NEW YORK
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State | NY
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Zip | 10128-4953
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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 | OWNER
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Name | LEV BORUKHOV
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Credential |
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Telephone | 718-791-9423
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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 | 035276
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 033914
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License Number State | NY
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