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General NPI Number Information
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NPI Number | 1609016625
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Entity Type | Organization
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Legal Business Name | BODYALIGN PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 331 W 57TH ST #401
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City | NEW YORK
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State | NY
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Zip | 10019-3101
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Country | US
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Telephone | 212-956-0762
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Fax |
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Provider Business Mailing Address
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Address Line | 331 W 57TH ST #401
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City | NEW YORK
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State | NY
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Zip | 10019-3101
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Country | US
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Telephone | 212-956-0762
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | JILL HOEFS
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Credential | MPT
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Telephone | 212-956-0762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 024115
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License Number State | NY
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