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General NPI Number Information
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NPI Number | 1699159830
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 777 WHITE PLAINS RD
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City | SCARSDALE
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State | NY
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Zip | 10583-5000
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Country | US
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Telephone | 914-771-6200
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Fax | 914-771-6202
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Provider Business Mailing Address
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Address Line | 576 BROADHOLLOW RD
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City | MELVILLE
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State | NY
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Zip | 11747-5002
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Country | US
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Telephone | 718-819-6800
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Fax | 347-841-9109
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Authorized Official
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Title or Position | VP OF ADMINISTRATIVE OPERATIONS
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Name | LETICIA PABELLON
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Credential |
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Telephone | 516-321-2447
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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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