Provider Demographics
NPI:1356113203
Name:MANZON PHYSICAL THERAPY
Entity type:Organization
Organization Name:MANZON PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-373-4832
Mailing Address - Street 1:340 W 55TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3766
Mailing Address - Country:US
Mailing Address - Phone:646-373-4832
Mailing Address - Fax:646-304-2030
Practice Address - Street 1:340 W 55TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3766
Practice Address - Country:US
Practice Address - Phone:646-373-4832
Practice Address - Fax:646-304-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty