Provider Demographics
NPI:1427584630
Name:EQUINOX PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:EQUINOX PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PAGAOA
Authorized Official - Last Name:ANDRES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-676-5775
Mailing Address - Street 1:407 ROCKAWAY AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212
Mailing Address - Country:US
Mailing Address - Phone:718-676-5775
Mailing Address - Fax:718-676-5774
Practice Address - Street 1:407 ROCKAWAY AVENUE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-676-5775
Practice Address - Fax:718-676-5774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-08
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy