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Organization
WALL STREET NY PHYSICAL THERAPY PC
Active
Organization
WALL STREET NY PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANCHU CHACKO (OWNER)
(646) 886-8687
Entity
Organization
Contact information
Practice address
26 BROADWAY STE 931, NEW YORK, NY 10004-1710
(646) 886-8687
(212) 656-1091
Mailing address
12 CENTER DR, NEW HYDE PARK, NY 11040-2302
(646) 886-8687
(212) 656-1091
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/05/2021
Last updated
09/06/2022
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