Mitra Physical Therapy
NPI #1154678258 in Douglaston, New York
Provider Information
- NPI Number
- 1154678258
- Entity Type
- Organization
- Organization Name
- Mitra Physical Therapy
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Aug 7, 2012
- Last Updated
- Aug 7, 2012
Practice Location
- Address
- 24312 73RD AVE FL 2
- City
- Douglaston
- State
- New York
- ZIP Code
- 11362-2320
- Phone
- (516) 451-3427
Authorized Official
- Name
- MR. THEODERICK I MITRA, PT
- Title
- PRESIDENT
- Phone
- (516) 451-3427
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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