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Organization
MAIN STREET PHYSICAL THERAPY AND HAND REHABILITATION OF KINGS PARK, PL
Active
Organization
MAIN STREET PHYSICAL THERAPY AND HAND REHABILITATION OF KINGS PARK, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FONTANA PTA (TREASURER)
(631) 269-6652
Entity
Organization
Contact information
Practice address
152 W MAIN STREET, KINGS PARK, NY 11754
(631) 269-6652
(631) 269-6654
Mailing address
152 W MAIN STREET, KINGS PARK, NY 11754
(631) 269-6652
(631) 269-6654
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
011230
NY
208100000X
Physical Medicine & Rehabilitation Physician
0227181
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NY
Other
Enumeration date
11/22/2006
Last updated
02/05/2015
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