Basic Information
| Provider Information | |||||||||
| NPI: | 1376738815 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FUNCTION BETTER PT PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3061 ROUTE 28 | ||||||||
| Address2: | |||||||||
| City: | HERKIMER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157170020 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3061 ROUTE 28 | ||||||||
| Address2: | |||||||||
| City: | HERKIMER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157170020 | ||||||||
| FaxNumber: | 3157170024 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | MARTIN | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 3157170020 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 03460235 | 05 | NY | MEDICAID |