Organization
PROTHERAPY REHABILITATION OT, PT, SLP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RUSSALETTE MAGBANUA MPS, OTR/L, CHT (CLINICAL DIRECTOR)
(917) 459-3695
Entity
Organization
Contact information
Practice address
866 E TREMONT AVE, BRONX, NY 10460-4201
(718) 589-2200
Mailing address
866 E TREMONT AVE, BRONX, NY 10460-4201
(718) 589-2200
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
012509
NY
261QP2000X
Physical Therapy Clinic/Center
022020
NY
261QR0400X
Rehabilitation Clinic/Center
Primary
010144
NY
Other
Enumeration date
11/12/2011
Last updated
11/12/2011
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