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General NPI Number Information
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NPI Number | 1598040016
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY SPECIALISTS OF NEW YORK, PLLC
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Dates
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Enumeration Date | 10/15/2011
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Last Update Date | 10/15/2011
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Provider Practice Location Address
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Address Line | 313 NASSAU BLVD
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City | GARDEN CITY
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State | NY
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Zip | 11530-5313
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Country | US
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Telephone | 516-307-1281
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Fax | 516-307-1282
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Provider Business Mailing Address
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Address Line | 313 NASSAU BLVD
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City | GARDEN CITY
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State | NY
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Zip | 11530-5313
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Country | US
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Telephone | 516-307-1281
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Fax | 516-307-1282
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | ELMER PADERON MABEZA
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Credential | PT
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Telephone | 516-307-1281
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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 |
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License Number State |
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