Organization
DORA SOURELOSMAPTPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DORA I AMAYA P.T. (PHYSICAL THERAPIST)
(347) 846-9799
Entity
Organization
Contact information
Practice address
1205 116TH ST, COLLEGE POINT, NY 11356-1540
(347) 846-9799
Mailing address
1205 116TH ST, COLLEGE POINT, NY 11356-1540
(347) 846-9799
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
013371
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689829467
EI
NY
Enumeration date
09/24/2014
Last updated
09/24/2014
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