Organization
FUNCTIONAL PHYSICAL THERAPY REHAB PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAQUIN CHARRIS (PRESIDENT)
(718) 424-5151
Entity
Organization
Contact information
Practice address
8131 BAXTER AVE, SUITE CD, ELMHURST, NY 11373-1315
(718) 424-5151
(718) 424-9119
Mailing address
8131 BAXTER AVE, SUITE CD, ELMHURST, NY 11373-1315
(718) 424-5151
(718) 424-9119
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
026983-1
NY
Other
Enumeration date
09/20/2009
Last updated
04/27/2012
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