Basic Information
| Provider Information | |||||||||
| NPI: | 1992381172 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CHRISTINE MEIZOSO PHYSICAL THERAPY, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 LEXINGTON AVE RM 401 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 101700403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163173946 | ||||||||
| FaxNumber: | 9173987874 | ||||||||
| Practice Location | |||||||||
| Address1: | 420 LEXINGTON AVE RM 401 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 101700403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163173946 | ||||||||
| FaxNumber: | 9173987874 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2021 | ||||||||
| LastUpdateDate: | 03/19/2021 | ||||||||
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| AuthorizedOfficialLastName: | MEIZOSO | ||||||||
| AuthorizedOfficialFirstName: | CHRISTINE MEIZOSO | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5163173946 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.