Organization
AVANTGARDE REHABILITATION LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIKTORIYA KHOMENKO DPT (OWNER)
(718) 605-1300
Entity
Organization
Contact information
Practice address
520 BLOOMINGDALE RD, STATEN ISLAND, NY 10309-2061
(718) 605-1300
(718) 605-8739
Mailing address
8 BUR CT, MANALAPAN, NJ 07726-1878
(732) 995-9293
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8002032
NY
Other
Enumeration date
04/02/2013
Last updated
07/14/2025
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