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General NPI Number Information
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NPI Number | 1669956876
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Entity Type | Organization
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Legal Business Name | CORE PHYSICAL THERAPY OF QUEENS PC
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 150-47B 14TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357
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Country | US
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Telephone | 917-285-2927
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Fax | 917-285-2938
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Provider Business Mailing Address
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Address Line | 150-47B 14TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357
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Country | US
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Telephone | 917-285-2927
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Fax | 917-285-2938
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DENISE SERRANO
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Credential |
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Telephone | 347-592-0841
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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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