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Organization

FUNCTION BUILDER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIA JUSON P.T. (PHYSICAL THERAPIST)
(917) 293-8821
Entity
Organization

Contact information

Practice address
7210 164TH ST, FRESH MEADOWS, NY 11365-4222
(718) 591-2064
(718) 591-2064
Mailing address
7210 164TH ST, FRESH MEADOWS, NY 11365-4222
(718) 591-2064
(718) 591-2064

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
09/30/2019
Last updated
09/30/2019
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