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Organization
THERAPEUTIC PHYSICAL THERAPY PC
Active
Organization
THERAPEUTIC PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEILA MONTEFRIO HISOLE CEBALLOS BSPT (PRESIDENT)
(631) 839-4059
Entity
Organization
Contact information
Practice address
1570 OLD COUNTRY RD, WESTBURY, NY 11590-5238
(516) 338-0412
(516) 338-1106
Mailing address
15 MONMOUTH ST, DEER PARK, NY 11729-2514
(631) 839-4059
(631) 254-0784
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
019468
NY
Other
Enumeration date
02/02/2007
Last updated
09/12/2013
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