Organization
MAIN STREET PHYSICAL THERAPY AND HAND REHABILITATION OF KINGS PARK, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FONTANA PTA (TREASURER)
(631) 269-6652
Entity
Organization
Contact information
Practice address
152 W MAIN STREET, KINGS PARK, NY 11754
(631) 269-6652
(631) 269-6654
Mailing address
152 W MAIN STREET, KINGS PARK, NY 11754
(631) 269-6652
(631) 269-6654
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
011230
NY
208100000X
Physical Medicine & Rehabilitation Physician
0227181
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NY
Other
Enumeration date
11/22/2006
Last updated
02/05/2015
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