Doctor Name: | MR. EDWARD J MODZELEWSKI |
NPI Number: | 1568598316 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT MA |
License Number: | 2119 |
Business Practice Address: | 61 Fairview Street Huntington, NY - 117433532 |
Business Phone Number: | 6314273059 |
Business Fax Number: | 7184640301 |
Mailing Address: | 61 Fairview Street, HUNTINGTON |
State: | NY |
Postal Code: | 117433532 |
Phone Number: | 6314273059 |
Fax Number: | 7184640301 |
NPI Enumeration Date: | 02/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2119 |
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 |