Basic Information
| Provider Information | |||||||||
| NPI: | 1023777232 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CYNERGY PHYSICAL THERAPY GRAND CENTRAL PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 485 MADISON AVE FL 8 | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100225803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129802963 | ||||||||
| FaxNumber: | 2129747228 | ||||||||
| Practice Location | |||||||||
| Address1: | 165 SMITH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112016337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187952744 | ||||||||
| FaxNumber: | 6466255922 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2021 | ||||||||
| LastUpdateDate: | 12/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | CHAN | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 2129747252 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.