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Organization
ST, MICHAEL PHYSICAL THERAPY PC
Active
Organization
ST, MICHAEL PHYSICAL THERAPY PC
Active
Other names
St, Michael Physical Therapy PC
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WELLEN PT (PROVIDER)
(201) 888-1549
Entity
Organization
Contact information
Practice address
710 COURTLANDT AVE, BRONX, NY 10451-5055
(347) 270-1124
Mailing address
710 COURTLANDT AVE, BRONX, NY 10451-5055
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1715341
PT
NY
Enumeration date
11/17/2022
Last updated
11/17/2022
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