Organization
A NEW STRIDE P T S L P THERAPEUTIC SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE JOHN NICKEL CCC-SLP (DIRECTOR)
(718) 494-5923
Entity
Organization
Contact information
Practice address
1779 RICHMOND AVE, FL 3, STATEN ISLAND, NY 10314-3907
(718) 494-5923
Mailing address
1779 RICHMOND AVE, FL 3, STATEN ISLAND, NY 10314-3907
(718) 494-5923
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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