Organization
FERNANDO MORENO PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO MORENO JR. DPT (PHYSICAL THERAPIST)
(917) 306-0725
Entity
Organization
Contact information
Practice address
6050 KENNEDY BLVD E, APT 2G, WEST NEW YORK, NJ 07093-3901
(917) 306-0725
Mailing address
6050 KENNEDY BLVD E, APT 2G, WEST NEW YORK, NJ 07093-3901
(917) 306-0725
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
036219
NY
261QP2000X
Physical Therapy Clinic/Center
Primary
40QA015352001
NJ
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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