Basic Information
| Provider Information | |||||||||
| NPI: | 1235590027 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CYNERGY UPPER EXTREMITY PHYSICAL AND OCCUPATIONAL THERAPY, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 485 MADISON AVE | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100225803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129802963 | ||||||||
| FaxNumber: | 6468581858 | ||||||||
| Practice Location | |||||||||
| Address1: | 485 MADISON AVE | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100225803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129802963 | ||||||||
| FaxNumber: | 6468581858 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2016 | ||||||||
| LastUpdateDate: | 03/08/2016 | ||||||||
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| AuthorizedOfficialLastName: | GORMEZANO | ||||||||
| AuthorizedOfficialFirstName: | CYNTHIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9176802783 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225X00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.