| NPI | 1659779908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICRIS FORMOSO-SANTOS Physical Therapist 646-918-4670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01313000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 028196) |
| 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner | |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2021-02-08 |