NPI 1538124011

Mary Mewborn-Broadus

Practitioner Kinesiotherapist Jamaica, NY

Practice location

Address: 17900 Linden Blvd, Jamaica, NY 11425-0001
Phone: (718) 526-1000
Fax: (718) 298-8531
Mailing address: 11456 212th St, Cambria Heights, NY 11411-1018

Registered specialties

Kinesiotherapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 226300000X

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Registry record

NPI: 1538124011
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Apr 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.