Basic Information
| Provider Information | |||||||||
| NPI: | 1285831685 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HERE PHYSICAL THERAPY PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 E 60TH ST RM 206 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100227111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127654800 | ||||||||
| FaxNumber: | 2127654855 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 E 60TH ST RM 206 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100227111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127654800 | ||||||||
| FaxNumber: | 2127654855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2007 | ||||||||
| LastUpdateDate: | 05/03/2018 | ||||||||
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| AuthorizedOfficialLastName: | MISIURA | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2127654800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | P.T. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 010624-1 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.