Organization
MAIN STREET PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VENKATESAN SIVARAMAN P.T. (OWNER)
(516) 850-1285
Entity
Organization
Contact information
Practice address
51 FARREL ST, NEW HYDE PARK, NY 11040-2407
(516) 850-1285
Mailing address
51 FARREL ST, NEW HYDE PARK, NY 11040-2407
(516) 850-1285
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
017069-1
NY
Other
Enumeration date
07/31/2009
Last updated
05/02/2013
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