# INTERVENTIONAL PHYSICAL MEDICINE AND REHAB OF NEW YORK, PLLC

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

## Provider details

- **NPI number:** 1760043715
- **Authorized official:** TERESA RIVERA (OFFICE MANAGER)
- **Authorized official phone:** (516) 888-7614

## Contact information

- **Practice address:** 1615 NORTHERN BLVD, GR 1, MANHASSET, NY 11030
- **Practice address phone:** (516) 888-7614
- **Mailing address:** 8 SUMTER AVE, EAST WILLISTON, NY 11596-2433

## Taxonomy

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

## Other

- **Enumeration date:** 06/20/2019
- **Last updated:** 11/04/2021