Basic Information
Provider Information
NPI: 1760131403
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANK
FirstName: PHOEBE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1311 MAMARONECK AVE STE 140
Address2:  
City: WHITE PLAINS
State: NY
PostalCode: 106055224
CountryCode: US
TelephoneNumber: 2942944050
FaxNumber: 6317608306
Practice Location
Address1: 1919 CHESTNUT ST STE 104
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191033456
CountryCode: US
TelephoneNumber: 2155641110
FaxNumber: 2152272739
Other Information
ProviderEnumerationDate: 03/21/2022
LastUpdateDate: 03/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT030287PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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