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Organization
OPTIMAL REHABILITATION OT & PT, PLLC
Active
Organization
OPTIMAL REHABILITATION OT & PT, PLLC
Active
Parent organization
OPTIMAL REHABILITATION OT & PT, PLLC
Other names
OPTIMAL REHABILITATION OT & PT, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
OPTIMAL REHABILITATION OT & PT, PLLC
Authorized official
MR. IMANUEL FUZAILOV DPT (OWNER)
(917) 803-5276
Entity
Organization
Contact information
Practice address
721 MELROSE AVE, BRONX, NY 10455-1121
(718) 554-0064
(718) 554-0221
Mailing address
721 MELROSE AVE, BRONX, NY 10455-1121
(718) 554-0064
(718) 544-0221
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
013231
NY
174400000X
Specialist
Primary
031215
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03381106
—
NY
Enumeration date
11/12/2015
Last updated
08/23/2020
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