MEDICARE: DELIGHTFUL PT SERVICES P. C.

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
1	225100000X	Physical Therapist	PT013295	NY

General Provider Information

NPI Number	:	1528412152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELIGHTFUL PT SERVICES P. C.

Provider Business Mailing Address
First Line	:	955 YONKERS AVE STE B2
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10704-3062
Country	:	US
Telephone Number	:	877-415-6700
Fax Number	:	914-801-5955

Provider Business Practice Location Address
First Line	:	955 YONKERS AVE STE B2
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10704-3062
Country	:	US
Telephone Number	:	877-415-6700
Fax Number	:	914-801-5955

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID MOMAH
Credential	:	DPT
Telephone Number	:	877-415-6700

Provider Enumeration Date	:	04/20/2016
Last Update Date	:	07/26/2016

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