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Organization
MAMARONECK PHYSICAL THERAPY PC
Active
Organization
MAMARONECK PHYSICAL THERAPY PC
Active
Other names
Physical Therapy Associates of Queens
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER BAUTISTA MBA (ADMINISTRATOR)
(718) 606-2544
Entity
Organization
Contact information
Practice address
8202 GRAND AVE, SUITE 1A, ELMHURST, NY 11373-4133
(718) 606-2544
(718) 606-1077
Mailing address
8202 GRAND AVE, SUITE 1A, ELMHURST, NY 11373-4133
(718) 606-2544
(718) 606-1077
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24014
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0214844
—
NY
Enumeration date
10/17/2006
Last updated
06/20/2013
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