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Organization
OPTIMAL REHABILITATION OT&PT PLLC
Active
Organization
OPTIMAL REHABILITATION OT&PT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IMANUEL FUZAILOV DPT (PT/PHYSICAL THERAPIST)
(917) 803-5276
Entity
Organization
Contact information
Practice address
721 MELROSE AVE, BRONX, NY 10455-1121
(917) 803-5276
(718) 762-1510
Mailing address
16903 65TH AVE, FLOOR 2, FRESH MEADOWS, NY 11365-1923
(917) 803-5276
(718) 762-1510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
031215
NY
Other
Enumeration date
05/04/2011
Last updated
05/30/2012
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