Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mitra Physical Therapy

Organization Early Intervention Provider Agency · NPI 1154678258

Mitra Physical Therapy is an Early Intervention Provider Agency in Douglaston, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012

Practice location Address checks out

24312 73rd Ave Fl 2
Douglaston, NY 11362-2320
Phone: (516) 451-3427
Fax: (347) 235-0932
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Early Intervention Provider Agency (primary) Taxonomy 252Y00000X · Licence 018279 (NY)

Record details

NPI number1154678258
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theoderick Mitra — President · (516) 451-3427
NPI enumeratedAugust 7, 2012
Last updated in NPPESAugust 7, 2012
Mailing address24312 73rd Ave Fl 2, Douglaston, NY 11362-2320

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