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General NPI Number Information
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NPI Number | 1588328355
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Entity Type | Organization
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Legal Business Name | MOVE TOMORROW
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Dates
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Enumeration Date | 10/27/2021
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 1540 PITKIN AVE
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City | BROOKLYN
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State | NY
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Zip | 11212-4539
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Country | US
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Telephone | 929-414-2960
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Fax |
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Provider Business Mailing Address
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Address Line | 369 HOWARD AVE
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City | BROOKLYN
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State | NY
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Zip | 11233-3939
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Country | US
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Telephone | 347-779-1582
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Fax |
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Authorized Official
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Title or Position | INTERN
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Name | PROF. PTAH M. SHABAZZ-ST. CLAIRE
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Credential | PHD, DO
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Telephone | 929-414-2960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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