Basic Information
| Provider Information | |||||||||
| NPI: | 1215957626 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 569 E MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | BAY SHORE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117068505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316658645 | ||||||||
| FaxNumber: | 6316658646 | ||||||||
| Practice Location | |||||||||
| Address1: | 60 E 56TH ST | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100223204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126886095 | ||||||||
| FaxNumber: | 2126886596 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 01/18/2011 | ||||||||
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| AuthorizedOfficialLastName: | SMALL | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6316658645 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | N | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.