1225046899 NPI number — LOWER MANHATTAN PHYSICAL THERAPY & SPORTS REHAB, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225046899 NPI number — LOWER MANHATTAN PHYSICAL THERAPY & SPORTS REHAB, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOWER MANHATTAN PHYSICAL THERAPY & SPORTS REHAB, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225046899
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUWANEE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30024-0101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-571-3852
Provider Business Mailing Address Fax Number:
833-888-7868

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 EXCHANGE PL
Provider Second Line Business Practice Location Address:
SUITE 728
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10005-2701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-425-1060
Provider Business Practice Location Address Fax Number:
646-527-9021
Provider Enumeration Date:
08/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WATERS
Authorized Official First Name:
SEAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
412-654-3212

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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