Organization
EXECUTIVE PARK PT OF BRIARCLIFF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISA NIELI (BILLING MANAGER)
(914) 346-5175
Entity
Organization
Contact information
Practice address
565 N STATE RD, BRIARCLIFF, NY 10510-1523
(914) 263-3280
Mailing address
1034 N BROADWAY, YONKERS, NY 10701-1328
(914) 509-4640
(914) 509-4639
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
023806
—
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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