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General NPI Number Information
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NPI Number | 1710284559
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Entity Type | Organization
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Legal Business Name | CT PHYSICAL THERAPY CARE, P.C.
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 4310 52ND ST
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City | WOODSIDE
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State | NY
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Zip | 11377-4542
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Country | US
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Telephone | 347-989-7979
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Fax | 718-255-1288
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Provider Business Mailing Address
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Address Line | 4310 52ND ST
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City | WOODSIDE
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State | NY
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Zip | 11377-4542
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Country | US
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Telephone | 347-989-7979
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Fax | 718-255-1288
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Authorized Official
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Title or Position | OWNER
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Name | CHESTER JAY REGANIT TOLENTINO
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Credential | PHYSICAL THERAPIST
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Telephone | 347-989-7979
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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 | 029899
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License Number State | NY
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