Provider Demographics
NPI:1760081418
Name:GRAND CENTRAL ACUPUNCTURE AND PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:GRAND CENTRAL ACUPUNCTURE AND PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLADSHTEIN GOLDFINE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:917-270-6143
Mailing Address - Street 1:1122 FRANKLIN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1602
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1122 FRANKLIN AVE STE 102
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1602
Practice Address - Country:US
Practice Address - Phone:917-270-6143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty