# GA PHYSICAL THERAPY FOR ALL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205693819
- **Authorized official:** GYULNARA AVSHALUMOVA DPT (PT)
- **Authorized official phone:** (917) 697-2617

## Contact information

- **Practice address:** 38 CORAL CT, STATEN ISLAND, NY 10308-3534
- **Practice address phone:** (917) 697-2617
- **Mailing address:** 38 CORAL CT, STATEN ISLAND, NY 10308-3534
- **Mailing address phone:** (917) 697-2617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/29/2024
- **Last updated:** 03/15/2024