Organization
MIRACLE TOUCH PT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA BULANOV MS (PRESIDENT)
(917) 882-0550
Entity
Organization
Contact information
Practice address
2543 E 11TH ST, BROOKLYN, NY 11235-5011
(917) 882-0550
(718) 615-9409
Mailing address
2543 E 11TH ST, BROOKLYN, NY 11235-5011
(917) 882-0550
(718) 615-9409
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
020707
NY
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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