Basic Information
| Provider Information | |||||||||
| NPI: | 1578583985 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW YORK PHYSICAL THERAPY, PLLC | ||||||||
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| OtherOrganizationName: | COMPLETE CARE PHYSICAL THERAPY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 NEWHAM AVE | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117175624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6318132143 | ||||||||
| FaxNumber: | 8885526176 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 MANETTO HILL RD | ||||||||
| Address2: | SUITE #105A | ||||||||
| City: | PLAINVIEW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118031311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169325260 | ||||||||
| FaxNumber: | 8882155172 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GREENE | ||||||||
| AuthorizedOfficialFirstName: | CYNDI | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGED CARE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6318132143 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | X | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 261QP2000X | X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.