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General NPI Number Information
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NPI Number | 1962882316
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Entity Type | Organization
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Legal Business Name | DOMINIC S FARNAN
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 540 E 5TH ST 17
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City | NEW YORK
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State | NY
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Zip | 10009-6529
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Country | US
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Telephone | 347-328-4103
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Fax |
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Provider Business Mailing Address
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Address Line | 540 E 5TH ST 17
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City | NEW YORK
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State | NY
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Zip | 10009-6529
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Country | US
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Telephone | 347-328-4103
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DOMINIC S FARNAN
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Credential |
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Telephone | 347-328-4103
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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 | 036975
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License Number State | NY
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