Organization
ELITE PERFORMANCE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ROBERT DEFEO DPT (PRESIDENT)
(516) 280-8811
Entity
Organization
Contact information
Practice address
1325 FRANKLIN AVE, SUITE LL105, GARDEN CITY, NY 11530-1666
(516) 280-8811
(516) 280-8809
Mailing address
1325 FRANKLIN AVE, SUITE LL105, GARDEN CITY, NY 11530-1666
(516) 280-8811
(516) 280-8809
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
030387
NY
Other
Enumeration date
10/09/2009
Last updated
08/11/2014
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