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General NPI Number Information
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NPI Number | 1699185413
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY ULTRA PLLC
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 150 W 51ST ST APT 1123
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City | NEW YORK
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State | NY
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Zip | 10019-6836
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Country | US
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Telephone | 646-301-5893
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Fax |
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Provider Business Mailing Address
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Address Line | 150 W 51ST ST APT 1123
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City | NEW YORK
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State | NY
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Zip | 10019-6836
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Country | US
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Telephone | 646-301-5893
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BARBARA OGANIANTS
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Credential | PT
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Telephone | 646-301-5893
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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 | 028693
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License Number State | NY
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