Healthcare Provider Details

I. General information

NPI: 1750815593
Provider Name (Legal Business Name): SNYS PHYSICAL THERAPY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 WEST 185TH STREET
NEW YORK NY
10033-1634
US

IV. Provider business mailing address

172 PALISADE AVE
BOGOTA NJ
07603-1634
US

V. Phone/Fax

Practice location:
  • Phone: 845-527-8008
  • Fax: 201-820-4365
Mailing address:
  • Phone: 845-527-8008
  • Fax: 201-820-4365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number010909
License Number State
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMIR AZIZ
Title or Position: OWNER
Credential: DPT
Phone: 845-527-8008