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General NPI Number Information
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NPI Number | 1548501562
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Entity Type | Organization
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Legal Business Name | MIDTOWN EAST PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/15/2013
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 20 E 46TH ST SUITE 301
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City | NEW YORK
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State | NY
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Zip | 10017-2417
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Country | US
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Telephone | 212-922-0044
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Fax | 212-922-0042
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Provider Business Mailing Address
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Address Line | 20 E 46TH ST SUITE 301
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City | NEW YORK
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State | NY
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Zip | 10017-2417
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Country | US
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Telephone | 212-922-0044
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Fax | 212-922-0042
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREGORY TRAKHTENBERG
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Credential | MSPT
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Telephone | 212-922-0044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 020674
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License Number State | NY
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