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General NPI Number Information
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NPI Number | 1427331750
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Entity Type | Organization
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Legal Business Name | REHABILITATION AND PHYSICAL THERAPY SPECIALIST PC
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 09/22/2011
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Provider Practice Location Address
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Address Line | 7 E 93RD ST SUITE 2-B
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City | NEW YORK
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State | NY
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Zip | 10128-0665
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Country | US
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Telephone | 917-476-3012
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Fax |
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Provider Business Mailing Address
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Address Line | 26 DELAVAN AVE
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City | BEACON
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State | NY
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Zip | 12508-2012
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Country | US
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Telephone | 917-476-3012
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PASTOR TAMAYO
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Credential | PT, DPT
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Telephone | 917-476-3012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 016506
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License Number State | NY
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