Healthcare Provider Details

I. General information

NPI: 1285738203
Provider Name (Legal Business Name): MIDTOWN PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 FIELDSTON RD
BRONX NY
10463-2003
US

IV. Provider business mailing address

3601 FIELDSTON RD
BRONX NY
10463-2003
US

V. Phone/Fax

Practice location:
  • Phone: 347-427-4228
  • Fax: 347-503-0972
Mailing address:
  • Phone: 347-427-4228
  • Fax: 347-503-0972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number0258031
License Number StateNY

VIII. Authorized Official

Name: MRS. RACHEL WILLIAMS
Title or Position: PHYSICAL THERAPIST
Credential: MSPT
Phone: 347-427-4228