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Organization
T.A.G. THE ACADEMIC GYM LLC
Active
Organization
T.A.G. THE ACADEMIC GYM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CYRIL VIEIRA (PRESIDENT)
(833) 433-7323
Entity
Organization
Contact information
Practice address
51 MUKTANADA MARG, WALDEN, NY 12586-2352
(917) 861-5243
(845) 787-0198
Mailing address
51 CONTINENTAL DR, NEW WINDSOR, NY 12553-5609
(917) 861-5243
(917) 861-5243
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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