Provider Demographics
NPI:1699540302
Name:DYNAFLEX PT & PTA PLLC
Entity type:Organization
Organization Name:DYNAFLEX PT & PTA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABIAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-747-1287
Mailing Address - Street 1:22005 HEMPSTEAD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-2118
Mailing Address - Country:US
Mailing Address - Phone:917-747-1287
Mailing Address - Fax:
Practice Address - Street 1:1700 GREAT NECK RD
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-2723
Practice Address - Country:US
Practice Address - Phone:631-608-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty