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Organization
EXECUTIVE PARK PHYSICAL THERAPY
Active
Organization
EXECUTIVE PARK PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN HERNANDEZ PT (OWNER)
(914) 509-4640
Entity
Organization
Contact information
Practice address
1034 N BROADWAY, YONKERS, NY 10701-1303
(914) 509-4640
Mailing address
1034 N BROADWAY, YONKERS, NY 10701-1303
(914) 509-4640
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
023806
NY
Other
Enumeration date
02/27/2007
Last updated
08/22/2020
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