Organization
A LIST PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVELINO VERGARA DE CHAVEZ PT (PRESIDENT)
(646) 208-6108
Entity
Organization
Contact information
Practice address
11949 UNION TPKE APT 4C, FOREST HILLS, NY 11375-6109
(646) 208-6108
(646) 810-1036
Mailing address
11949 UNION TPKE APT 4C, FOREST HILLS, NY 11375-6109
(646) 208-6108
(646) 810-1036
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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