Organization
ADVANCED SPORTS, PHYSICAL & ORTHOPEDIC REHABILITATIVE THERAPY SERVICES
Active
Other names
Advanced S.P.O.R.T.S.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH P. CAPOBIANCO PT (VICE PRESIDENT)
(718) 820-9300
Entity
Organization
Contact information
Practice address
17660 UNION TPKE, SUITE 195, FRESH MEADOWS, NY 11366-1531
(718) 820-9300
(718) 820-9382
Mailing address
17660 UNION TPKE, SUITE 195, FRESH MEADOWS, NY 11366-1531
(718) 820-9300
(718) 820-9382
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N82127
HEALTHNET
NY
Enumeration date
10/31/2006
Last updated
08/22/2020
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