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General NPI Number Information
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NPI Number | 1447789409
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Entity Type | Organization
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Legal Business Name | EMORY PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 06/05/2017
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Provider Practice Location Address
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Address Line | 106-01 LIBERTY AV
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City | OZONE PARK
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State | NY
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Zip | 11417-1810
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Country | US
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Telephone | 917-405-8340
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Fax | 347-427-2526
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Provider Business Mailing Address
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Address Line | 1350 E MAIN ST UNIT 41
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City | SHRUB OAK
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State | NY
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Zip | 10588-7502
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Country | US
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Telephone | 917-405-8340
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Fax |
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Authorized Official
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Title or Position | OPERATION MANAGER
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Name | DR. ABIODUN O ADEYEMI
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Credential | DPT
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Telephone | 917-405-8340
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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 | 014645
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License Number State | NY
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