# PROTHERAPY REHABILITATION OT, PT, SLP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396022752
- **Authorized official:** MS. RUSSALETTE MAGBANUA MPS, OTR/L, CHT (CLINICAL DIRECTOR)
- **Authorized official phone:** (917) 459-3695

## Contact information

- **Practice address:** 866 E TREMONT AVE, BRONX, NY 10460-4201
- **Practice address phone:** (718) 589-2200
- **Mailing address:** 866 E TREMONT AVE, BRONX, NY 10460-4201
- **Mailing address phone:** (718) 589-2200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0700X | Hearing and Speech Clinic/Center | 012509 | NY | — |
| 261QP2000X | Physical Therapy Clinic/Center | 022020 | NY | — |
| 261QR0400X | Rehabilitation Clinic/Center | 010144 | NY | Yes |

## Other

- **Enumeration date:** 11/12/2011
- **Last updated:** 11/12/2011