Provider Demographics
NPI:1396202446
Name:MANUAL INTUITIVE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MANUAL INTUITIVE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:NAPHIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:PESCASIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-861-5475
Mailing Address - Street 1:42 RICHMOND TER
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1909
Mailing Address - Country:US
Mailing Address - Phone:718-673-6699
Mailing Address - Fax:718-673-6696
Practice Address - Street 1:42 RICHMOND TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1909
Practice Address - Country:US
Practice Address - Phone:718-673-6699
Practice Address - Fax:718-673-6696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty