Provider Demographics
NPI:1205268281
Name:ADVANCING FORWARD PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:ADVANCING FORWARD PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:JACINTO
Authorized Official - Last Name:VALERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-217-2172
Mailing Address - Street 1:40 MEMORIAL HWY
Mailing Address - Street 2:17N
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-8312
Mailing Address - Country:US
Mailing Address - Phone:347-217-2172
Mailing Address - Fax:
Practice Address - Street 1:40 MEMORIAL HWY
Practice Address - Street 2:17N
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-8312
Practice Address - Country:US
Practice Address - Phone:347-217-2172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031221251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health