Basic Information
| Provider Information | |||||||||
| NPI: | 1528012267 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINE | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | ZACHARY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.S.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 348 WARBURTON AVE | ||||||||
| Address2: | |||||||||
| City: | HASTINGS ON HUDSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107062809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144789390 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 313 CENTRAL PARK AVE | ||||||||
| Address2: | |||||||||
| City: | SCARSDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105831349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149465685 | ||||||||
| FaxNumber: | 9149460304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 04/08/2008 | ||||||||
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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 | 022861-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251S0007X | 022861-1 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | 2251X0800X | 022861-1 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.