MEDICARE: LYNN CULBERTSON PHYSICAL THERAPY PLLC

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
1	261QP2000X	Physical Therapy Clinic/Center	030322	NY

General Provider Information

NPI Number	:	1497133771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNN CULBERTSON PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	1312 LYDIA CT
Second Line	:
City	:	MOHEGAN LAKE
State	:	NY
Zip	:	10547-1907
Country	:	US
Telephone Number	:	914-743-7111
Fax Number	:	914-743-7100

Provider Business Practice Location Address
First Line	:	1887 E MAIN ST
Second Line	:
City	:	MOHEGAN LAKE
State	:	NY
Zip	:	10547-1249
Country	:	US
Telephone Number	:	914-743-7111
Fax Number	:	914-743-7100

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. LYNN ANN CULBERTSON
Credential	:	DPT
Telephone Number	:	914-714-3794

Provider Enumeration Date	:	05/07/2015
Last Update Date	:	08/16/2023

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