Organization
FRESH POND PHYSICAL THERAPY, P.C
Active
Parent organization
FRESH POND PHYSICAL THERAPY, P.C
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESH POND PHYSICAL THERAPY, P.C
Authorized official
MR. DEXTER C BONGATO PT (STAFF PHYSICAL THERAPIST)
(718) 456-2545
Entity
Organization
Contact information
Practice address
6805 FRESH POND RD, RIDGEWOOD, NY 11385-5200
(718) 456-2545
(718) 559-6784
Mailing address
6805 FRESH POND RD, RIDGEWOOD, NY 11385-5200
(718) 456-2545
(718) 559-6784
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
0363571
NY
Other
Enumeration date
07/01/2015
Last updated
07/20/2015
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