1578210290 NPI number — PERSONAL TOUCH MEDICAL OF THROGS NECK REHABILITATION & PHYSICAL MED

Table of content: (NPI 1578210290)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578210290 NPI number — PERSONAL TOUCH MEDICAL OF THROGS NECK REHABILITATION & PHYSICAL MED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERSONAL TOUCH MEDICAL OF THROGS NECK REHABILITATION & PHYSICAL MED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PERSONAL TOUCH PHYSICAL MEDICINE MGMT SVCES INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578210290
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3485 E TREMONT AVE STE 1B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10465-2016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-828-1549
Provider Business Mailing Address Fax Number:
718-828-5029

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4446 BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10040-2939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-828-1549
Provider Business Practice Location Address Fax Number:
718-828-5029
Provider Enumeration Date:
03/02/2022

Additional Information

Authorized Official

Authorized Official Last Name:
APONTE
Authorized Official First Name:
MARISOL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
917-821-0246

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com