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General NPI Number Information
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NPI Number | 1699129734
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Entity Type | Organization
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Legal Business Name | RESILIENT PERFORMANCE PHYSICAL THERAPY
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 377 PARK AVE S FL 2
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City | NEW YORK
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State | NY
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Zip | 10016-8807
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Country | US
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Telephone | 929-429-5086
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Fax |
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Provider Business Mailing Address
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Address Line | 377 PARK AVE S FL 2
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City | NEW YORK
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State | NY
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Zip | 10016-8807
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Country | US
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Telephone | 929-429-5086
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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 | TREVOR RAPPA
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Credential | DPT
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Telephone | 309-824-5130
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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 | 038952
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License Number State | NY
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