Organization
AQUA HEALTH PHYSICAL THERAPY PC
Active
Organization
AQUA HEALTH PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VITALIY GONIKMAN DPT (PRESIDENT)
(718) 687-8027
Entity
Organization
Contact information
Practice address
2753 CONEY ISLAND AVE, BROOKLYN, NY 11235-5015
(718) 769-8400
(718) 769-3255
Mailing address
1523 VOORHIES AVE FL 1, BROOKLYN, NY 11235-3912
(718) 769-8400
(718) 769-3255
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/24/2006
Last updated
06/21/2021
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