Basic Information
| Provider Information | |||||||||
| NPI: | 1417160490 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SYRACUSE PHYSICAL THERAPY PARTNERS | ||||||||
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| OtherOrganizationName: | AQUACARE PHYSICAL THERAPY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 38069 TOWN CENTER DR UNIT 15 | ||||||||
| Address2: | |||||||||
| City: | MILLVILLE | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199676968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025393110 | ||||||||
| FaxNumber: | 3025397237 | ||||||||
| Practice Location | |||||||||
| Address1: | 38069 TOWN CENTER DR UNIT 15 | ||||||||
| Address2: | |||||||||
| City: | MILLVILLE | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199676968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025393110 | ||||||||
| FaxNumber: | 3025397237 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2007 | ||||||||
| LastUpdateDate: | 05/01/2012 | ||||||||
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| AuthorizedOfficialLastName: | BALDWIN | ||||||||
| AuthorizedOfficialFirstName: | JANICE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | REGIONAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4105487600 | ||||||||
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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 | 225400000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.