1851527147 NPI number — ADVANCED PHYSICAL THERAPY OF NEW YORK PLLC

Table of content: (NPI 1851527147)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851527147 NPI number — ADVANCED PHYSICAL THERAPY OF NEW YORK PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED 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:
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:
1851527147
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
532 NEPTUNE AVE RM 209
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11224-4008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-372-7300
Provider Business Mailing Address Fax Number:
718-372-4233

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
532 NEPTUNE AVE RM 209
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11224-4008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-372-7300
Provider Business Practice Location Address Fax Number:
718-372-4233
Provider Enumeration Date:
06/01/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FELDMAN
Authorized Official First Name:
IAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICAL THERAPIST
Authorized Official Telephone Number:
718-372-7300

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  025951 , 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)

  • Identifier: P3930513 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2566049 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".