Basic Information
| Provider Information | |||||||||
| NPI: | 1194936005 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | QUEENS HANDS- ON PHYSICAL THERAPY. P.C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9001A ROOSEVELT AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | JACKSON HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113727938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182054911 | ||||||||
| FaxNumber: | 7182055946 | ||||||||
| Practice Location | |||||||||
| Address1: | 9001A ROOSEVELT AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | JACKSON HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113727938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182054911 | ||||||||
| FaxNumber: | 7182055946 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2007 | ||||||||
| LastUpdateDate: | 03/12/2009 | ||||||||
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| AuthorizedOfficialLastName: | AYARZA | ||||||||
| AuthorizedOfficialFirstName: | LILIANA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST SENIOR | ||||||||
| AuthorizedOfficialTelephone: | 7182054911 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 019399 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.