Organization
DYNAMIC REHAB PT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANATOLI YOSHOVAYEV DPT (PHYSICAL THERAPIST)
(917) 977-0096
Entity
Organization
Contact information
Practice address
316 N 6TH ST, PROSPECT PARK, NJ 07508-2122
(973) 910-0307
(718) 233-2570
Mailing address
8502 139TH ST APT 3E, BRIARWOOD, NY 11435-2649
(917) 977-0096
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0292741
NY
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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