Basic Information
| Provider Information | |||||||||
| NPI: | 1306050604 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MANHATTAN PHYSICAL MEDICINE & REHABILITATION, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 133 E 58TH ST STE 811 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100221299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124720077 | ||||||||
| FaxNumber: | 2124724127 | ||||||||
| Practice Location | |||||||||
| Address1: | 133 E 58TH ST STE 811 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124720077 | ||||||||
| FaxNumber: | 2124724127 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2007 | ||||||||
| LastUpdateDate: | 07/11/2018 | ||||||||
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| AuthorizedOfficialLastName: | CAMERON | ||||||||
| AuthorizedOfficialFirstName: | KATIE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2124720077 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.