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General NPI Number Information
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NPI Number | 1942114459
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Entity Type | Organization
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Legal Business Name | ACTIVE PHYSIO CARE PT PLLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 1922 MULFORD AVE FL 2
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City | BRONX
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State | NY
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Zip | 10461-4009
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Country | US
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Telephone | 646-784-1736
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Fax | --
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Provider Business Mailing Address
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Address Line | 1922 MULFORD AVE FL 2
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City | BRONX
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State | NY
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Zip | 10461-4009
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Country | US
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Telephone | 646-784-1736
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Fax | --
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Authorized Official
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Title or Position | OWNER
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Name | CATHRYN MANGUILIN PECSON
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Credential | PT, DPT, CLT
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Telephone | 646-784-1736
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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 |
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License Number State | NULL
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