Organization
SOURCE OF PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGARITA MUGURUZA PT (OWNER)
(718) 880-8468
Entity
Organization
Contact information
Practice address
4051 JUNCTION BLVD FL 2, CORONA, NY 11368-2121
(718) 880-8468
Mailing address
4051 JUNCTION BLVD FL 2, CORONA, NY 11368-2121
(718) 880-8468
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
025885
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03434104
—
NY
Enumeration date
07/02/2013
Last updated
07/02/2013
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