Provider Demographics
NPI:1144867748
Name:MYOTHERAEX GLOBAL LLC
Entity type:Organization
Organization Name:MYOTHERAEX GLOBAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:OZARAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-435-5190
Mailing Address - Street 1:636 BARNES AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4015
Mailing Address - Country:US
Mailing Address - Phone:917-435-5190
Mailing Address - Fax:
Practice Address - Street 1:1789 SHEEPSHEAD BAY RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2792
Practice Address - Country:US
Practice Address - Phone:908-902-1964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty