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Organization
NEW YORK PHYSICAL THERAPY SPORTS REHABILITATION PLLC
Active
Organization
NEW YORK PHYSICAL THERAPY SPORTS REHABILITATION PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOSTAS D KOUTSOUBIS PT (PRES)
(718) 428-7171
Entity
Organization
Contact information
Practice address
4402 FRANCIS LEWIS BLVD, BAYSIDE, NY 11361-3041
(718) 428-7171
(718) 428-7174
Mailing address
4402 FRANCIS LEWIS BLVD, BAYSIDE, NY 11361-3041
(718) 428-7171
(718) 428-7174
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0220661
NY
Other
Enumeration date
05/21/2007
Last updated
12/11/2013
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