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General NPI Number Information
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NPI Number | 1750572897
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Entity Type | Organization
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Legal Business Name | BRONX REHABILITATION MEDICINE & PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 984 MORRIS PARK AVE
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City | BRONX
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State | NY
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Zip | 10462-3714
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Country | US
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Telephone | 718-823-7676
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Fax | 718-823-7675
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Provider Business Mailing Address
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Address Line | 984 MORRIS PARK AVE
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City | BRONX
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State | NY
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Zip | 10462-3714
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Country | US
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Telephone | 718-823-7676
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Fax | 718-823-7675
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DR. ALBERT VILLAFUERTE
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Credential | MD
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Telephone | 718-823-7676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 202599
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License Number State | NY
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