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General NPI Number Information
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NPI Number | 1750535936
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Entity Type | Organization
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Legal Business Name | PROMOBILITY PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 552 BROADWAY STE 502
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City | NEW YORK
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State | NY
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Zip | 10012-3922
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Country | US
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Telephone | 917-757-5135
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Fax | 917-522-9623
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Provider Business Mailing Address
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Address Line | 100 MEMPHIS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-3404
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Country | US
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Telephone | 917-757-5135
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Fax | 917-522-9623
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. WING MUN WONG-TOM
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Credential | PT, MS, DPT
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Telephone | 917-757-5135
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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 |
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License Number State |
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