| Doctor Name: | TATI B HARSONO |
| NPI Number: | 1407152622 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 021060-1 |
| Business Practice Address: | 500 Bi County Blvd Suite 210n Farmingdale, NY - 117353988 |
| Business Phone Number: | 7182641640 |
| Business Fax Number: | |
| Mailing Address: | 384 Cedar Ave, RIDGEWOOD |
| State: | NJ |
| Postal Code: | 074505112 |
| Phone Number: | 3474249686 |
| Fax Number: | 6468615926 |
| NPI Enumeration Date: | 02/04/2011 |
| NPI Last Update Date: | 02/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 021060-1 |
| 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 |