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General NPI Number Information
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NPI Number | 1841507993
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Entity Type | Organization
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Legal Business Name | LISA NATHANSON, P.T. P.C.
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 659 SHORE RD 7B
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City | LONG BEACH
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State | NY
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Zip | 11561-4681
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Country | US
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Telephone | 516-633-2945
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Fax |
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Provider Business Mailing Address
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Address Line | 659 SHORE RD 7B
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City | LONG BEACH
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State | NY
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Zip | 11561-4681
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Country | US
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Telephone | 516-633-2945
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MS. LISA NATHANSON
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Credential | P.T.
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Telephone | 516-633-2945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 007273
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License Number State | NY
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