Organization
CEDAR MOUNTAIN INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BENNETT KORODY M.S. P.T. L.AC. (PRESIDENT)
(347) 610-1688
Entity
Organization
Contact information
Practice address
303 5TH AVE RM 309, NEW YORK, NY 10016-6695
(347) 610-1688
Mailing address
303 5TH AVE RM 309, NEW YORK, NY 10016-6695
(347) 610-1688
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
004284
NY
261QP2000X
Physical Therapy Clinic/Center
011620
NY
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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