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General NPI Number Information
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NPI Number | 1396202446
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Entity Type | Organization
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Legal Business Name | MANUAL INTUITIVE PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 42 RICHMOND TER
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City | STATEN ISLAND
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State | NY
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Zip | 10301-1909
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Country | US
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Telephone | 718-673-6699
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Fax | 718-673-6696
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Provider Business Mailing Address
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Address Line | 42 RICHMOND TER
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City | STATEN ISLAND
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State | NY
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Zip | 10301-1909
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Country | US
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Telephone | 718-673-6699
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Fax | 718-673-6696
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Authorized Official
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Title or Position | PRACTICE CONSULTANT
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Name | NAPHIZA PESCASIO
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Credential |
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Telephone | 732-861-5475
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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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