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General NPI Number Information
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NPI Number | 1700180940
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Entity Type | Organization
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Legal Business Name | JABEZ PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 1520 56TH ST LOWER LEVEL
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City | BROOKLYN
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State | NY
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Zip | 11219-4737
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Country | US
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Telephone | 917-238-9554
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Fax |
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Provider Business Mailing Address
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Address Line | 6125 98TH ST SUITE 16-N
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City | REGO PARK
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State | NY
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Zip | 11374-1418
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Country | US
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Telephone | 917-238-9554
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS MADELEINE LINSANGAN
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Credential | P.T.
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Telephone | 917-238-9554
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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 | 23714-1
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License Number State | NY
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