MEDICARE: DUFFY-RATH PHYSICAL THERAPY, 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1790889780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUFFY-RATH PHYSICAL THERAPY, PC

Provider Business Mailing Address
First Line	:	PO BOX 4808
Second Line	:	CARRIER WELLNESS CENTER - TR-19
City	:	SYRACUSE
State	:	NY
Zip	:	13221-4808
Country	:	US
Telephone Number	:	315-432-7500
Fax Number	:	315-432-6244

Provider Business Practice Location Address
First Line	:	6304 THOMPSON ROAD
Second Line	:	CARRIER WELLNESS CENTER - BLDG. TR-19
City	:	SYRACUSE
State	:	NY
Zip	:	13206
Country	:	US
Telephone Number	:	315-432-7500
Fax Number	:	315-432-6244

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JEAN D RATH
Credential	:
Telephone Number	:	315-432-7500

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	08/12/2010

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