Organization
BENSONHURST PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNESTO NOBLEZA VILLAS JR. PT (PRESIDENT)
(347) 204-6099
Entity
Organization
Contact information
Practice address
1706 CROPSEY AVE, SUITE C, D, BROOKLYN, NY 11214-5861
(718) 259-1010
(718) 259-3705
Mailing address
1706 CROPSEY AVE, SUITE C, D, BROOKLYN, NY 11214-5861
(718) 259-1010
(718) 259-3705
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022729
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02109079
—
NY
Enumeration date
07/30/2012
Last updated
07/30/2012
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