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General NPI Number Information
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NPI Number | 1457806036
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Entity Type | Organization
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Legal Business Name | SPORTS PHYSICAL THERAPY OCCUPATIONAL THERAPY AND REHABILITATION SERVIC
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 210 E 64TH ST 5TH FLOOR
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City | NEW YORK CITY
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State | NY
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Zip | 10021-2000
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Country | US
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Telephone | 212-434-4263
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Fax |
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Provider Business Mailing Address
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Address Line | 972 BRUSH HOLLOW RD FL 4
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City | WESTBURY
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State | NY
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Zip | 11590-1740
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Country | US
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Telephone | 516-321-7526
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Fax |
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Authorized Official
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Title or Position | VP
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Name | DANIEL VAKNIN
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Credential |
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Telephone | 516-321-7801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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