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General NPI Number Information
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NPI Number | 1679173579
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Entity Type | Organization
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Legal Business Name | AMERICAN EDGE PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 1889 LINCOLN AVE
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City | EAST MEADOW
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State | NY
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Zip | 11554-2522
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Country | US
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Telephone | 516-659-4904
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Fax |
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Provider Business Mailing Address
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Address Line | 1889 LINCOLN AVE
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City | EAST MEADOW
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State | NY
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Zip | 11554-2522
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Country | US
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Telephone | 516-659-4904
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CRAIG YELLIN
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Credential |
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Telephone | 516-984-6926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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