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General NPI Number Information
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NPI Number | 1932827524
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Entity Type | Organization
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Legal Business Name | JPG PHYSICAL THERAPY P.C.
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 1115 BROADWAY STE 1042
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City | NEW YORK
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State | NY
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Zip | 10010-3450
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Country | US
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Telephone | 929-328-7233
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Fax |
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Provider Business Mailing Address
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Address Line | 15 JOAN CT
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City | HOLTSVILLE
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State | NY
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Zip | 11742-1212
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Country | US
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Telephone | 929-328-7233
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN PAUL GALVAN
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Credential | DPT
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Telephone | 929-328-7233
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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 |
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License Number State |
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