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General NPI Number Information
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NPI Number | 1942545264
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC ENERGY OF WESTBURY, INC
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 10 WEDGEWOOD DR
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City | WESTBURY
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State | NY
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Zip | 11590-2825
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Country | US
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Telephone | 516-398-4339
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Fax | 516-706-1833
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Provider Business Mailing Address
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Address Line | 10 WEDGEWOOD DR
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City | WESTBURY
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State | NY
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Zip | 11590-2825
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Country | US
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Telephone | 516-398-4339
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Fax | 516-706-1833
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. GAIL CAMPBELL
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Credential | PT, MS
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Telephone | 516-398-4339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 021553-1
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License Number State | NY
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