Provider Demographics
NPI:1851562755
Name:STRETCH & RELIEF PHYSICAL THERAPY AND REHABILITATION, P.C.
Entity Type:Organization
Organization Name:STRETCH & RELIEF PHYSICAL THERAPY AND REHABILITATION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:JOVENAL
Authorized Official - Last Name:NERONA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-701-4923
Mailing Address - Street 1:PO BOX 234
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-0234
Mailing Address - Country:US
Mailing Address - Phone:347-701-4923
Mailing Address - Fax:914-457-4826
Practice Address - Street 1:3202 UNION ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3049
Practice Address - Country:US
Practice Address - Phone:347-701-4923
Practice Address - Fax:914-457-4826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023460-1261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)