Individual
NATAN THEISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
10740 QUEENS BLVD STE 207, FOREST HILLS, NY 11375-4252
(718) 261-3100
(718) 261-2915
Mailing address
6740 BOOTH ST APT 2A, FOREST HILLS, NY 11375-2757
(646) 420-5149
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
048315
NY
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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