Organization
A TO Z PHYSICAL THERAPY PC
Active
Organization
A TO Z PHYSICAL THERAPY PC
Active
Other names
Back to Motion Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KISHORE KANDURI (SOLE PRORIETER)
(917) 318-5303
Entity
Organization
Contact information
Practice address
8610 151ST AVE, SUITE # LK, HOWARD BEACH, NY 11414-1332
(917) 318-5303
Mailing address
113 TIVED LN E, EDISON, NJ 08837-3077
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100098026
MEDICARE PTAN
NY
Enumeration date
06/20/2006
Last updated
06/01/2016
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