Healthcare Provider Details
I. General information
NPI: 1265640015
Provider Name (Legal Business Name): VORTEX PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1075 HARLEMVILLE RD
GHENT NY
12075-1901
US
IV. Provider business mailing address
56 FERN HILL RD
GHENT NY
12075-3902
US
V. Phone/Fax
- Phone: 518-281-2890
- Fax:
- Phone: 518-281-2890
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
YOTAM
LEV
Title or Position: PHYSICAL THERAPIST-OWNER
Credential: PT, DPT
Phone: 518-281-2890