Provider Demographics
NPI:1659611283
Name:MAESTRO PHYSICAL THERAPY AND REHABILITATION, P.C.
Entity Type:Organization
Organization Name:MAESTRO PHYSICAL THERAPY AND REHABILITATION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CAMPO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:917-696-2079
Mailing Address - Street 1:424 W 110TH ST
Mailing Address - Street 2:SUITE 15A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2408
Mailing Address - Country:US
Mailing Address - Phone:347-676-1371
Mailing Address - Fax:
Practice Address - Street 1:424 W 110TH ST
Practice Address - Street 2:SUITE 15A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2408
Practice Address - Country:US
Practice Address - Phone:347-676-1371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy