1275901886 NPI number — PLAY AND GROW PHYSICAL THERAPY AND SPEECH LANGUAGE PATHOLOGY PLLC

Table of content: (NPI 1275901886)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275901886 NPI number — PLAY AND GROW PHYSICAL THERAPY AND SPEECH LANGUAGE PATHOLOGY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLAY AND GROW PHYSICAL THERAPY AND SPEECH LANGUAGE PATHOLOGY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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Provider Other Name Prefix Text:
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NPI Number Information

NPI Number:
1275901886
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 DARROW PL
Provider Second Line Business Mailing Address:
SUITE 24E
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10475-1802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-837-9711
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 DARROW PL
Provider Second Line Business Practice Location Address:
SUITE 24E
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10475-1802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-837-9711
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/14/2015

Additional Information

Authorized Official

Authorized Official Last Name:
FRANCIS
Authorized Official First Name:
SANDY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PHYSICAL THERAPIST
Authorized Official Telephone Number:
917-837-9712

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X , with the licence number:  021351 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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