Organization
AGE ACTIVELY PHYSICAL THERAPY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDGAR JOSEPH BIAZON PT (PRESIDENT)
(516) 343-6195
Entity
Organization
Contact information
Practice address
1633 WESTERVELT AVE, NORTH BALDWIN, NY 11510-1650
(516) 343-6195
(516) 208-5005
Mailing address
1633 WESTERVELT AVE, NORTH BALDWIN, NY 11510-1650
(516) 343-6195
(516) 208-5005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
017711-1
NY
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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