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General NPI Number Information
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NPI Number | 1699540302
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Entity Type | Organization
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Legal Business Name | DYNAFLEX PT & PTA PLLC
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Dates
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Enumeration Date | 11/22/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 1700 GREAT NECK RD
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City | COPIAGUE
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State | NY
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Zip | 11726-2723
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Country | US
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Telephone | 631-608-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 22005 HEMPSTEAD AVE APT 2
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City | QUEENS VILLAGE
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State | NY
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Zip | 11429-2118
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Country | US
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Telephone | 917-747-1287
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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 | MRS. MYRA LABIAL
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Credential | PT
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Telephone | 917-747-1287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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