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General NPI Number Information
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NPI Number | 1972892446
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Entity Type | Organization
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Legal Business Name | NYSSPT, INC.
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | 1829 HOBART AVE
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City | BRONX
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State | NY
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Zip | 10461-4117
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Country | US
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Telephone | 347-810-7637
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Fax | 347-810-7638
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Provider Business Mailing Address
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Address Line | 1829 HOBART AVE
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City | BRONX
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State | NY
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Zip | 10461-4117
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Country | US
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Telephone | 347-810-7637
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Fax | 347-810-7638
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KARN SANTIKUL
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Credential | DPT
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Telephone | 347-810-7637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 026668-1
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License Number State | NY
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