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General NPI Number Information
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NPI Number | 1437196706
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Entity Type | Organization
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Legal Business Name | PINOY PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 12/23/2013
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Provider Practice Location Address
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Address Line | 4024 82ND ST FL 2
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City | ELMHURST
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State | NY
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Zip | 11373-1305
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Country | US
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Telephone | 718-426-9595
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Fax | 718-426-2729
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Provider Business Mailing Address
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Address Line | 4024 82ND ST FL 2
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City | ELMHURST
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State | NY
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Zip | 11373-1305
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Country | US
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Telephone | 718-426-9595
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Fax | 718-426-2729
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Authorized Official
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Title or Position | OWNER PYSICAL THERAPIST
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Name | MR. BOGNAY DURY DOMANAS
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Credential | LICENSE PT
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Telephone | 718-426-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0259211
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License Number State | NY
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