Basic Information
| Provider Information | |||||||||
| NPI: | 1336546928 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ALTMAN | ||||||||
| FirstName: | SEAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 SURREY RD | ||||||||
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| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 069033215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147145300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 530 MAIN ST | ||||||||
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| City: | ARMONK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105041843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142739100 | ||||||||
| FaxNumber: | 9142739101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2014 | ||||||||
| LastUpdateDate: | 11/29/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 011175 | CT | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 038378 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.