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Organization
GENERATION NEXTWAVE
Active
Organization
GENERATION NEXTWAVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN L. CONZO (PHYSICAL THERAPIST)
(631) 921-1277
Entity
Organization
Contact information
Practice address
41 CHURCH RD, GREAT RIVER, NY 11739-3023
(631) 921-1277
(631) 277-0944
Mailing address
PO BOX 799, GREAT RIVER, NY 11739-0799
(631) 921-1277
(631) 277-0944
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
018199-1
NY
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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