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NPI Code Detail

MEDICARE: PREMIER PHYSICAL THERAPY AND WELLNESS OF KATOWAH, PC

MEDICARE: PREMIER PHYSICAL THERAPY AND WELLNESS OF KATOWAH, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1043203680
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER PHYSICAL THERAPY AND WELLNESS OF KATOWAH, PC
Provider Business Mailing Address
First Line : 1536 3RD AVE
Second Line : 5TH FL
City : NEW YORK
State : NY
Zip : 10028-2167
Country : US
Telephone Number : 212-861-2630
Fax Number :
Provider Business Practice Location Address
First Line : 223 KATONAH AVE
Second Line :
City : KATONAH
State : NY
Zip : 10536-2146
Country : US
Telephone Number : 914-232-1480
Fax Number : 914-232-3341
Authorized Official
Title or Position : OWNER
Name : JOSEPH TATTA
Credential :
Telephone Number : 212-249-5332
Provider Enumeration Date : 08/30/2005
Last Update Date : 10/03/2013

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Directions to “PREMIER PHYSICAL THERAPY AND WELLNESS OF KATOWAH, PC ” Practice Location

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