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Organization
ST MICHAEL PT PC
Active
Organization
ST MICHAEL PT PC
Active
Other names
PHYSICAL THERAPY SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONNIE BARGAYO RPT (OWNER/PRESIDENT)
(347) 586-2271
Entity
Organization
Contact information
Practice address
3409 MURRAY ST FL 2, FLUSHING, NY 11354-3948
(718) 888-1704
Mailing address
8604 GRAND AVE APT 2K, ELMHURST, NY 11373-4316
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
032350
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1077179924
MEDICARE, HMO, MAJOR MEDS
NY
Enumeration date
12/26/2017
Last updated
06/16/2018
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