Basic Information
| Provider Information | |||||||||
| NPI: | 1194055723 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PROGRESSIVE PHYSICAL THERAPY SERVICES OF NEW YORK, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 SCENIC HILLS DR | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126033723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452428270 | ||||||||
| FaxNumber: | 8452150070 | ||||||||
| Practice Location | |||||||||
| Address1: | 1987 STATE ROUTE 52 EAST | ||||||||
| Address2: | SUITE 11 | ||||||||
| City: | LIBERTY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 127548317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452928580 | ||||||||
| FaxNumber: | 8452928909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2010 | ||||||||
| LastUpdateDate: | 03/08/2010 | ||||||||
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| AuthorizedOfficialLastName: | GREENFIELD | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 8452428270 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 010664 | NY | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.