Organization
WYCKOFF PHYSICAL THERAPY PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY TAN (BILLING & COLLECTION DEPT. HEAD)
(718) 456-2543
Entity
Organization
Contact information
Practice address
6805 FRESH POND RD, RIDGEWOOD, NY 11385-5200
(718) 456-2543
(718) 559-6784
Mailing address
201 SAINT NICHOLAS AVE, BROOKLYN, NY 11237-4840
(718) 821-9511
(718) 559-6784
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2015
Last updated
05/20/2016
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