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General NPI Number Information
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NPI Number | 1649961772
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Entity Type | Organization
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Legal Business Name | CARP PHYSICAL THERAPY P.C.
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 399 LAKE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-2640
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Country | US
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Telephone | 718-442-8813
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Fax |
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Provider Business Mailing Address
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Address Line | 8402 143RD ST APT 302
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City | JAMAICA
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State | NY
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Zip | 11435-2657
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Country | US
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Telephone | 646-704-2190
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLENE ARK REYES PIAD
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Credential | DPT
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Telephone | 718-442-8813
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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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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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