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General NPI Number Information
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NPI Number | 1518332410
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Entity Type | Organization
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Legal Business Name | UNIVERSAL THERAPY SERVICES P C
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 1111 MIDLAND AVE # IG
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City | BRONXVILLE
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State | NY
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Zip | 10708-6333
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Country | US
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Telephone | 718-210-6637
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Fax | 678-253-5914
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Provider Business Mailing Address
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Address Line | 1111 MIDLAND AVE # IG
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City | BRONXVILLE
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State | NY
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Zip | 10708-6333
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Country | US
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Telephone | 718-210-6637
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Fax | 678-253-5914
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID NONYELUM MOMAH
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Credential | DPT
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Telephone | 718-210-6637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | PT013295
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT013295
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License Number State | NY
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