Organization Name: | HOME ADVANTAGE PHYSICAL THERAPY PC |
NPI Number: | 1134454119 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN T MANGAN (OWNER) |
Mailing Address: | 106 Frederick St Oceanside |
State: | NY US |
Postal Code: | 115724709 |
Phone Number: | 5163179593 |
Fax Number: | 5167645323 |
NPI Enumeration Date: | 10/09/2009 |
NPI Last Update Date: | 04/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 014577-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |