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NPI Code Detail

MEDICARE: ONE ON ONE PHYSICAL THERAPY OF FOREST AVENUE PC

MEDICARE: ONE ON ONE PHYSICAL THERAPY OF FOREST AVENUE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1417298001
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONE ON ONE PHYSICAL THERAPY OF FOREST AVENUE PC
Provider Business Mailing Address
First Line : 31 NEW DORP LN
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10306-2351
Country : US
Telephone Number : 718-370-3500
Fax Number : 718-979-5236
Provider Business Practice Location Address
First Line : 1351 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10302-2049
Country : US
Telephone Number : 718-390-0067
Fax Number : 718-390-0060
Authorized Official
Title or Position : OWNER
Name : RICHARD BODIAN
Credential :
Telephone Number : 718-370-3500
Provider Enumeration Date : 03/07/2013
Last Update Date : 03/07/2013

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Directions to “ONE ON ONE PHYSICAL THERAPY OF FOREST AVENUE PC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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