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Organization
FRESH POND PHYSICAL THERAPY GREENPOINT, P.C
Active
Organization
FRESH POND PHYSICAL THERAPY GREENPOINT, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZA TAN DPT,PT (CEO)
(718) 456-2545
Entity
Organization
Contact information
Practice address
6805 FRESH POND RD, RIDGEWOOD, NY 11385-5200
(718) 456-2545
(718) 559-6784
Mailing address
1007 MANHATTAN AVE, BROOKLYN, NY 11222-1313
(718) 383-7361
(718) 383-7371
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
015401-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100103715
P TAN
NY
Enumeration date
04/12/2012
Last updated
07/28/2016
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