Organization
BIG STRIDES WIDE REACH OT, PT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARMAINE MORCILLA PT (PT/MANAGING PARTNER)
(718) 880-1911
Entity
Organization
Contact information
Practice address
11940 METROPOLITAN AVE, SUITE 105, KEW GARDENS, NY 11415-2600
(718) 880-1911
(718) 487-3425
Mailing address
11940 METROPOLITAN AVE, SUITE 105, KEW GARDENS, NY 11415-2600
(718) 880-1911
(718) 487-3425
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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