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General NPI Number Information
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NPI Number | 1700397668
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Entity Type | Organization
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Legal Business Name | EMILY WARD PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/18/2017
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Last Update Date | 10/18/2017
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Provider Practice Location Address
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Address Line | 1 RANDALLS IS
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City | NEW YORK
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State | NY
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Zip | 10035-5197
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Country | US
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Telephone | 601-331-2645
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 YORK AVE APT 5FS
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City | NEW YORK
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State | NY
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Zip | 10075-0036
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMILY WARD
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Credential |
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Telephone | 601-331-2645
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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 | 040237
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License Number State | NY
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