Organization
ST CHARLES REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENDON HOWARD NOLAN DPT (PHYSICAL THERAPIST)
(631) 312-2834
Entity
Organization
Contact information
Practice address
77 ROUTE 112 STE F, PATCHOGUE, NY 11772-1230
(631) 207-2370
(631) 758-1748
Mailing address
77 ROUTE 112 STE F, PATCHOGUE, NY 11772-1230
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
038336
NY
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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