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Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Active
Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN AGRELO (EXECUTIVE DIRECTOR OF BUSINESS OPS)
(516) 794-3278
Entity
Organization
Contact information
Practice address
14 WALL ST, NEW YORK, NY 10005-2101
(516) 794-3278
(516) 750-9076
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(516) 794-3278
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
024135
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q4WFH1
PTAN
NY
Enumeration date
01/06/2011
Last updated
03/30/2018
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