Basic Information
| Provider Information | |||||||||
| NPI: | 1871781237 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CYNERGY PHYSICAL THERAPY, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 145 W 57TH ST | ||||||||
| Address2: | 10TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100192220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129747252 | ||||||||
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| Practice Location | |||||||||
| Address1: | 145 W 57TH ST | ||||||||
| Address2: | 10TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100192220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129747252 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2007 | ||||||||
| LastUpdateDate: | 10/11/2007 | ||||||||
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| AuthorizedOfficialLastName: | GORMEZANO | ||||||||
| AuthorizedOfficialFirstName: | CYNTHIA | ||||||||
| AuthorizedOfficialMiddleName: | REBECCA | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2129747252 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.