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Organization
LEGENDARY THERAPY
Active
Organization
LEGENDARY THERAPY
Active
Parent organization
LEGENDARY THERAPY
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEGENDARY THERAPY
Authorized official
MRS. RACHEL WEIS (DIRECTOR)
(917) 460-7098
Entity
Organization
Contact information
Practice address
91-63 110ST, RICHMOND HILL, NY 11418
(917) 723-6653
Mailing address
9163 110TH ST, RICHMOND HILL, NY 11418-2310
(917) 723-6653
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
24582
NY
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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