Healthcare Provider Details

I. General information

NPI: 1780701722
Provider Name (Legal Business Name): APALACHIN PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6843 STATE ROUTE 434 SUITE 1
APALACHIN NY
13732-3503
US

IV. Provider business mailing address

6843 STATE ROUTE 434 SUITE 1
APALACHIN NY
13732-3503
US

V. Phone/Fax

Practice location:
  • Phone: 607-625-2022
  • Fax: 607-625-2022
Mailing address:
  • Phone: 607-625-2022
  • Fax: 607-625-2022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number023397
License Number StateNY

VIII. Authorized Official

Name: TRUPTI MAYUR KANERIA
Title or Position: OWNER
Credential: P.T.
Phone: 607-727-3154