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General NPI Number Information
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NPI Number | 1669610341
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Entity Type | Organization
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Legal Business Name | PARK AVENUE PHYSICAL THERAPY & REHABILITATION PLLC
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 40 PARK AVE SUITE 5
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City | NEW YORK
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State | NY
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Zip | 10016-3467
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Country | US
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Telephone | 646-288-1748
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Fax | 212-889-6150
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Provider Business Mailing Address
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Address Line | 40 PARK AVE SUITE 5
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City | NEW YORK
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State | NY
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Zip | 10016-3467
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Country | US
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Telephone | 646-288-1748
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Fax | 212-889-6150
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Authorized Official
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Title or Position | REHABILITATION DIRECTOR
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Name | MR. JOSEPH M SIMON
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Credential | PT, DPT
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Telephone | 917-309-2224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 023472-1
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License Number State | NY
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