Organization
EXECUTIVE PARK ORTHOPEDIC & SPORTS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAN HERNANDEZ DPT (PRESIDENT)
(914) 509-4640
Entity
Organization
Contact information
Practice address
1034 N BROADWAY, 2ND FLOOR, YONKERS, NY 10701-1303
(914) 509-4640
(914) 509-4639
Mailing address
1034 N BROADWAY, 2ND FLOOR, YONKERS, NY 10701-1328
(914) 509-4640
(914) 509-4639
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
023806
NY
Other
Enumeration date
04/04/2007
Last updated
04/23/2024
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