Basic Information
| Provider Information | |||||||||
| NPI: | 1083744874 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALESTIS | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | P.T. O.C.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1015 SAW MILL RIVER RD | ||||||||
| Address2: | |||||||||
| City: | ARDSLEY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105021118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144001500 | ||||||||
| FaxNumber: | 9144001500 | ||||||||
| Practice Location | |||||||||
| Address1: | 1727 BROADWAY | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100195214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127654800 | ||||||||
| FaxNumber: | 2127654855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2007 | ||||||||
| LastUpdateDate: | 09/21/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 019075-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.