Provider Demographics
NPI:1932178969
Name:PISLA-KHALIL, BOZENA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:BOZENA
Middle Name:
Last Name:PISLA-KHALIL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 DUKE DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1207
Mailing Address - Country:US
Mailing Address - Phone:917-747-1771
Mailing Address - Fax:516-570-0484
Practice Address - Street 1:13 DUKE DR
Practice Address - Street 2:
Practice Address - City:MANHASSET HILLS
Practice Address - State:NY
Practice Address - Zip Code:11040-1207
Practice Address - Country:US
Practice Address - Phone:917-747-1771
Practice Address - Fax:516-570-0484
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist