Organization
LEXINGTON COREWORK PT LLC
Active
Other names
Lexington Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
IAN MARI MICABALO PT, OCS, CPI (PROPRIETOR)
(212) 888-4780
Entity
Organization
Contact information
Practice address
686 LEXINGTON AVE, SUITE 3S, NEW YORK, NY 10022-2614
(212) 888-4780
(212) 888-4782
Mailing address
686 LEXINGTON AVE, SUITE 3S, NEW YORK, NY 10022-2614
(212) 888-4780
(212) 888-4782
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
NY
Other
Enumeration date
01/29/2016
Last updated
03/22/2016
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