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HOME PT OF NYC, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOB BECERRA P.T. (OWNER/CEO)
(646) 853-5315
Entity
Organization

Contact information

Practice address
1375 BROADWAY, FL 3, NEW YORK, NY 10018-7001
(646) 853-5315
(866) 863-8148
Mailing address
1375 BROADWAY, FL 3, NEW YORK, NY 10018-7001
(646) 853-5315
(866) 863-8148

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
012422-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012422-1
NYS LICENSE NUMBER
NY
01
Q38641
PTAN
NY
Enumeration date
09/14/2010
Last updated
01/13/2011
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