Basic Information
Provider Information
NPI: 1497992812
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOLONY
FirstName: JOSEPH
MiddleName: THOMAS
NamePrefix:  
NameSuffix: JR.
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214823
CountryCode: US
TelephoneNumber: 2126061225
FaxNumber:  
Practice Location
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214823
CountryCode: US
TelephoneNumber: 2126061225
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/08/2009
LastUpdateDate: 04/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251S0007XDAPT002414PAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
225100000XPT007941LPAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X0592919NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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