Organization
TATAY NINONG PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KRISTIAN MANGUBAT RPT (MANAGER/OWNER)
(347) 605-7946
Entity
Organization
Contact information
Practice address
7909B NORTHERN BLVD, JACKSON HEIGHTS, NY 11372-1223
(718) 507-1438
(718) 507-1530
Mailing address
3344 105TH ST APT 3, CORONA, NY 11368-1121
(347) 605-7946
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
029005
NY
Other
Enumeration date
10/22/2013
Last updated
05/14/2014
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