Healthcare Provider Details

I. General information

NPI: 1164763108
Provider Name (Legal Business Name): MARYBETH WETZEL BATES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 MAIN ST
ARMONK NY
10504-1860
US

IV. Provider business mailing address

357 MAIN ST
ARMONK NY
10504-1860
US

V. Phone/Fax

Practice location:
  • Phone: 914-273-0800
  • Fax: 914-273-9287
Mailing address:
  • Phone: 914-273-0800
  • Fax: 914-273-9287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number012576-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: