Basic Information
| Provider Information | |||||||||
| NPI: | 1639356595 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSICAL THERAPY ARTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 594 BROADWAY | ||||||||
| Address2: | SUITE 1207 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100123289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123431500 | ||||||||
| FaxNumber: | 2123431594 | ||||||||
| Practice Location | |||||||||
| Address1: | 594 BROADWAY | ||||||||
| Address2: | SUITE 1207 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100123289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123431500 | ||||||||
| FaxNumber: | 2123431594 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2008 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | ZINS | ||||||||
| AuthorizedOfficialFirstName: | FRANIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2123431500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | M.S., P.T. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
ID Information
| ID | Type | State | Issuer | Description | P419903 | 01 | NY | OXFORD | OTHER | Q64292 | 01 | NY | EMPIRE BC/BS | OTHER |