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General NPI Number Information
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NPI Number | 1811380744
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Entity Type | Organization
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Legal Business Name | KEEP IN ACTION PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 12 APPLETREE LN
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City | GREAT NECK
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State | NY
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Zip | 11024-1926
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Country | US
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Telephone | 718-413-6685
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Fax | 212-889-9655
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Provider Business Mailing Address
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Address Line | 12 APPLETREE LN
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City | GREAT NECK
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State | NY
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Zip | 11024-1926
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Country | US
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Telephone | 718-413-6685
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Fax | 212-889-9655
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIA LAZAR
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Credential | PT
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Telephone | 718-413-6685
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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 | 026613
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License Number State | NY
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