Provider Demographics
NPI:1992381172
Name:CHRISTINE MEIZOSO PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:CHRISTINE MEIZOSO PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE MEIZOSO
Authorized Official - Middle Name:
Authorized Official - Last Name:MEIZOSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-317-3946
Mailing Address - Street 1:420 LEXINGTON AVE RM 401
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10170-0403
Mailing Address - Country:US
Mailing Address - Phone:516-317-3946
Mailing Address - Fax:917-398-7874
Practice Address - Street 1:420 LEXINGTON AVE RM 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10170-0403
Practice Address - Country:US
Practice Address - Phone:516-317-3946
Practice Address - Fax:917-398-7874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy