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Organization

A.R.C. PHYSICAL THERAPY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. AMADO EDGARDO CONANAN P.T. (PRESIDENT/ OWNER)
(917) 660-6095
Entity
Organization

Contact information

Practice address
5718 WOODSIDE AVE FL 2, WOODSIDE, NY 11377-3444
(718) 205-0030
Mailing address
5718 WOODSIDE AVE FL 2, WOODSIDE, NY 11377-3444
(718) 205-0030

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022161
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02527282
NY
Enumeration date
02/24/2009
Last updated
02/24/2009
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