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General NPI Number Information
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NPI Number | 1699886705
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Entity Type | Organization
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Legal Business Name | SURDI PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/11/2008
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Provider Practice Location Address
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Address Line | 133 POMONA RD
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City | POMONA
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State | NY
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Zip | 10970-3526
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Country | US
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Telephone | 845-362-0229
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Fax | 845-362-0229
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Provider Business Mailing Address
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Address Line | 133 POMONA RD
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City | POMONA
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State | NY
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Zip | 10970-3526
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Country | US
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Telephone | 845-362-0229
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Fax | 845-362-0229
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Authorized Official
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Title or Position | PHYSICAL THERAPY CO DIRECTOR
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Name | MRS. HARRIET INA SURDI
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Credential | PT
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Telephone | 845-362-0229
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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 | 6003
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License Number State | NY
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