Organization
PROHEALTH AND FITNESS PT OT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES NUSSBAUM (CLINICAL DIRECTOR)
(212) 600-4781
Entity
Organization
Contact information
Practice address
180 W END AVE, SUITE 1M, NEW YORK, NY 10023-4902
(212) 600-4781
(800) 655-3780
Mailing address
180 W END AVE, SUITE 1M, NEW YORK, NY 10023-4902
(212) 600-4781
(800) 655-3780
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03271592
—
NY
Enumeration date
01/05/2011
Last updated
08/23/2011
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