Organization
GOOD SHEPHERD PHYSICAL THERAPY PLLC
Active
Other names
Good Shepherd Physical Therapy PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN LAQUI DPT (DPT)
(201) 660-0968
Entity
Organization
Contact information
Practice address
107 E BROADWAY FL 3, NEW YORK, NY 10002-7037
(201) 660-0968
(212) 233-0898
Mailing address
107 E BROADWAY FL 3, NEW YORK, NY 10002-7037
(212) 233-0889
(212) 233-0898
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386023018
—
NY
Enumeration date
09/17/2018
Last updated
10/12/2021
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