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General NPI Number Information
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NPI Number | 1750188447
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Entity Type | Organization
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Legal Business Name | LG PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 1800 WARING AVE
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City | BRONX
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State | NY
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Zip | 10469-6331
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Country | US
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Telephone | 917-434-6358
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Fax |
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Provider Business Mailing Address
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Address Line | 3213 HAMILTON WAY
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City | NEW WINDSOR
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State | NY
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Zip | 12553-4957
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Country | US
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Telephone | 917-434-6358
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JEFFREY ALTAMIRANO
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Credential |
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Telephone | 917-434-6358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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