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Organization
MAIN PHYSICAL THERAPY PC
Active
Organization
MAIN PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANA GONCHAROVA (MED BILLER)
(718) 775-8717
Entity
Organization
Contact information
Practice address
1701 W 5TH ST, BROOKLYN, NY 11223-1403
(718) 440-6253
(347) 673-7904
Mailing address
1701 W 5TH ST, BROOKLYN, NY 11223-1403
(718) 440-6253
(347) 673-7904
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022064
NY
Other
Enumeration date
01/12/2011
Last updated
01/12/2011
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