# SOURCE OF PHYSICAL THERAPY PC

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

## Provider details

- **NPI number:** 1619317815
- **Authorized official:** MS. MARGARITA MUGURUZA PT (OWNER)
- **Authorized official phone:** (718) 880-8468

## Contact information

- **Practice address:** 4051 JUNCTION BLVD FL 2, CORONA, NY 11368-2121
- **Practice address phone:** (718) 880-8468
- **Mailing address:** 4051 JUNCTION BLVD FL 2, CORONA, NY 11368-2121
- **Mailing address phone:** (718) 880-8468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 025885 | NY | Yes |

## Other

- **Enumeration date:** 07/02/2013
- **Last updated:** 07/02/2013