Healthcare Provider Details

I. General information

NPI: 1821659152
Provider Name (Legal Business Name): EFEKTIV-PT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 SAINT ROSE PKWY UNIT 1169
HENDERSON NV
89052-3545
US

IV. Provider business mailing address

3080 SAINT ROSE PKWY UNIT 1169
HENDERSON NV
89052-3545
US

V. Phone/Fax

Practice location:
  • Phone: 914-787-9130
  • Fax:
Mailing address:
  • Phone: 914-787-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN LEE SMITH
Title or Position: CEO
Credential: PT
Phone: 914-787-9130