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General NPI Number Information
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NPI Number | 1942234877
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Entity Type | Organization
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Legal Business Name | SAINT MARY PHYSICAL THERAPY P.C.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 2071 CLOVE RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-1671
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Country | US
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Telephone | 917-545-9249
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Fax |
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Provider Business Mailing Address
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Address Line | 2071 CLOVE RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-1671
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Country | US
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Telephone | 917-545-9249
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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 | MR. USAMA ABDUL-SAYED HANNA JR.
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Credential | P.T.
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Telephone | 917-545-9249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 025663
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License Number State | NY
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