Provider Demographics
NPI:1700387206
Name:MY PHYSICAL THERAPY & ACUPUNCTURE PLLC
Entity Type:Organization
Organization Name:MY PHYSICAL THERAPY & ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-886-8979
Mailing Address - Street 1:14238 37TH AVE STE 1D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4580
Mailing Address - Country:US
Mailing Address - Phone:718-886-8979
Mailing Address - Fax:718-228-9172
Practice Address - Street 1:14238 37TH AVE STE 1D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4580
Practice Address - Country:US
Practice Address - Phone:718-866-8979
Practice Address - Fax:718-228-9172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-21
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026971225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty