Basic Information
| Provider Information | |||||||||
| NPI: | 1538223219 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENDRES | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 W 77TH ST | ||||||||
| Address2: | APT 46 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100245151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9176015558 | ||||||||
| FaxNumber: | 2128291189 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 E 56TH ST | ||||||||
| Address2: | SUITE 1010 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100223607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127592211 | ||||||||
| FaxNumber: | 2128291189 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2251X0800X | 017646 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.