Provider Demographics
NPI:1063824225
Name:MANUAL PHYSICAL THERAPY AND NURSING CARE, PT AND RN, PLLC
Entity Type:Organization
Organization Name:MANUAL PHYSICAL THERAPY AND NURSING CARE, PT AND RN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:SOLEDAD
Authorized Official - Last Name:PASCUAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:201-647-9343
Mailing Address - Street 1:825 WALTON AVENUE
Mailing Address - Street 2:AT 158 STREET
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-402-1800
Mailing Address - Fax:718-402-2366
Practice Address - Street 1:825 WALTON AVE
Practice Address - Street 2:AT 158 STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2306
Practice Address - Country:US
Practice Address - Phone:718-402-1800
Practice Address - Fax:718-402-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029278261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy