Organization
LEGENDARY THERAPY
Active
Parent organization
LEGENDARY THERAPY
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEGENDARY THERAPY
Authorized official
MRS. RACHEL WEIS (DIRECTOR)
(917) 460-7098
Entity
Organization
Contact information
Practice address
91-63 110ST, RICHMOND HILL, NY 11418
(917) 723-6653
Mailing address
9163 110TH ST, RICHMOND HILL, NY 11418-2310
(917) 723-6653
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
24582
NY
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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