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General NPI Number Information
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NPI Number | 1801055736
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Entity Type | Organization
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Legal Business Name | BODYWISE PHYSICAL THERAPY AND PILATES PC
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 1556 3RD AVE STE 604
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City | NEW YORK
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State | NY
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Zip | 10128-3161
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Country | US
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Telephone | 646-867-1474
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Fax | 866-748-5034
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Provider Business Mailing Address
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Address Line | 444 E 84TH ST APT 2F
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City | NEW YORK
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State | NY
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Zip | 10028-6240
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Country | US
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Telephone | 646-867-1474
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Fax | 866-748-5034
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Authorized Official
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Title or Position | OWNER
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Name | GAIL L KING
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Credential | PT, DPT
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Telephone | 646-867-1474
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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 | 007485
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License Number State | NY
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