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Organization
SHARE A SMILE PHYSICAL THERPAY PC
Active
Organization
SHARE A SMILE PHYSICAL THERPAY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANOOP CHACKO PT (OWNER)
(718) 707-6970
Entity
Organization
Contact information
Practice address
39-07 PRINCE ST 5A, FLUSHING, NY 11354-5357
(929) 422-3880
(718) 732-1307
Mailing address
524 JERUSALEM AVE, HICKSVILLE, NY 11801-5526
(929) 422-3880
(718) 732-1307
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251E1300X
Clinical Electrophysiology Physical Therapist
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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