| Organization Name: | EVERSHARP PHYSICAL THERAPY PC |
| NPI Number: | 1003959941 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL J DISTEFANO (OWNER) |
| Mailing Address: | 7215 Grand Ave Maspeth |
| State: | NY US |
| Postal Code: | 113781525 |
| Phone Number: | 7188032058 |
| Fax Number: | 7184269155 |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 08/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 012611 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |