1730316365 NPI number — WESTMINSTER PHYSICAL THERAPY OF NEW YORK PLLC

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 1730316365 NPI number — WESTMINSTER PHYSICAL THERAPY OF NEW YORK PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTMINSTER PHYSICAL THERAPY OF NEW YORK PLLC
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:
WESTMINSTER PHYSICAL THERAPY
Provider Other Organization Name Type Code:
5
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:
1730316365
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6433 98TH ST
Provider Second Line Business Mailing Address:
STE. LL1
Provider Business Mailing Address City Name:
REGO PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11374-3321
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-544-6677
Provider Business Mailing Address Fax Number:
718-544-6688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6433 98TH ST
Provider Second Line Business Practice Location Address:
STE. LL1
Provider Business Practice Location Address City Name:
REGO PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11374-3321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-544-6677
Provider Business Practice Location Address Fax Number:
718-544-6688
Provider Enumeration Date:
06/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
TUPAZ
Authorized Official First Name:
ALVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-544-6677

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  024252 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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