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General NPI Number Information
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NPI Number | 1942947015
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Entity Type | Organization
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Legal Business Name | RM GUTIERREZ PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 05/19/2022
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 500 OLD COUNTRY RD STE 300
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City | GARDEN CITY
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State | NY
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Zip | 11530-1944
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Country | US
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Telephone | 718-909-4597
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Fax |
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Provider Business Mailing Address
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Address Line | 95 MAYFAIR AVE
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City | FLORAL PARK
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State | NY
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Zip | 11001-2446
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Country | US
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Telephone | 718-909-4597
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIT
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Name | MARIFE ALFONSO-GUTIERREZ
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Credential | PT
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Telephone | 718-909-4597
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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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