Provider Demographics
NPI:1538460126
Name:ETERNITY PHYSICAL THERAPY PC.
Entity Type:Organization
Organization Name:ETERNITY PHYSICAL THERAPY PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DARLENZY
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBOUZE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-977-1550
Mailing Address - Street 1:150 BROADWAY
Mailing Address - Street 2:SUITE 1302
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038
Mailing Address - Country:US
Mailing Address - Phone:212-785-1651
Mailing Address - Fax:
Practice Address - Street 1:150 BROADWAY
Practice Address - Street 2:SUITE 1302
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038
Practice Address - Country:US
Practice Address - Phone:212-785-1651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0315902251X0800X
246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty