Organization
EVERSHARP PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J DISTEFANO PT (OWNER)
(718) 803-2058
Entity
Organization
Contact information
Practice address
7215 GRAND AVE, MASPETH, NY 11378-1525
(718) 803-2058
(718) 426-9155
Mailing address
7215 GRAND AVE, MASPETH, NY 11378-1525
(718) 803-2058
(718) 426-9155
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
012611
NY
Other
Enumeration date
02/14/2007
Last updated
08/26/2011
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