Provider Demographics
NPI:1417188913
Name:MANHATTAN THERAPEUTIC RESEARCH FOUNDATION
Entity Type:Organization
Organization Name:MANHATTAN THERAPEUTIC RESEARCH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIEVIC
Authorized Official - Middle Name:EBORA
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:718-285-0588
Mailing Address - Street 1:37 W 26TH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1006
Mailing Address - Country:US
Mailing Address - Phone:718-285-0588
Mailing Address - Fax:718-285-9323
Practice Address - Street 1:37 W 26TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1006
Practice Address - Country:US
Practice Address - Phone:718-285-0588
Practice Address - Fax:718-285-9323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty