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General NPI Number Information
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NPI Number | 1871869610
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Entity Type | Organization
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Legal Business Name | SPORTSLABNYC, LLC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 15 WEST 39TH STREET FLOOR 4
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City | NEW YORK
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State | NY
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Zip | 10018
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Country | US
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Telephone | 212-764-0270
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Fax | 212-764-0275
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Provider Business Mailing Address
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Address Line | 15 WEST 39TH STREET FLOOR 4
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City | NEW YORK
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State | NY
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Zip | 10018
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Country | US
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Telephone | 212-764-0270
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Fax | 212-764-0275
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Authorized Official
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Title or Position | CEO
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Name | MR. NAZEER ALI
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Credential |
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Telephone | 212-764-0270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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