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General NPI Number Information
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NPI Number | 1992233357
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Entity Type | Organization
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Legal Business Name | KINETICS PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1440 OUTLOOK AVE APT 1
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City | BRONX
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State | NY
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Zip | 10465-1157
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Country | US
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Telephone | 917-292-3130
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 OUTLOOK AVE APT 1
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City | BRONX
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State | NY
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Zip | 10465-1157
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Country | US
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Telephone | 917-292-3130
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PEACHY MAY REYES
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Credential |
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Telephone | 917-292-3130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 020513
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 20513
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License Number State | NY
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