Organization
FIT FOR LIFE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL J POKER PT (OWNER)
(516) 804-9078
Entity
Organization
Contact information
Practice address
2473 MERRICK RD, BELLMORE, NY 11710-5705
(516) 804-9078
(516) 804-9081
Mailing address
2473 MERRICK RD, BELLMORE, NY 11710-5705
(516) 804-9078
(516) 804-9081
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
013149
NY
Other
Enumeration date
11/14/2006
Last updated
02/04/2011
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