Provider Demographics
NPI:1851963524
Name:PRIME MOTION PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:PRIME MOTION PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZHVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-824-0662
Mailing Address - Street 1:3424 KINGSBRIDGE AVE APT 1H
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4002
Mailing Address - Country:US
Mailing Address - Phone:718-884-2460
Mailing Address - Fax:888-543-7447
Practice Address - Street 1:3424 KINGSBRIDGE AVE APT 1H
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4002
Practice Address - Country:US
Practice Address - Phone:718-884-2460
Practice Address - Fax:888-543-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy