Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Sep 22, 2020
License(s)
PT028801 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1377 MOTOR PKWY STE 307 | Islandia, NY 11749-5258 | 914-265-4595 |
| LOCATION | 3400 ARAMINGO AVE STE 11 | Philadelphia, PA 19134-4531 | 215-203-1930 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.