Organization
LUGO COMPREHENSIVE PT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN E LUGO PT, ECS (OWNER)
(646) 361-1501
Entity
Organization
Contact information
Practice address
515 NECKAR AVE, STATEN ISLAND, NY 10304-4511
(646) 361-1501
Mailing address
117 CHARLOTTE TER, ROSELLE PARK, NJ 07204-2406
(646) 361-1501
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
025272
NY
261QP2000X
Physical Therapy Clinic/Center
22051
MD
261QP2000X
Physical Therapy Clinic/Center
40QA01210900
NJ
261QP2000X
Physical Therapy Clinic/Center
PT019858
PA
Other
Enumeration date
03/15/2007
Last updated
05/22/2012
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