Healthcare Provider Details
I. General information
NPI: 1396265104
Provider Name (Legal Business Name): SNYS PHYSICAL THERAPY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
629 W 185TH ST
NEW YORK NY
10033-3102
US
IV. Provider business mailing address
172 PALISADE AVE
BOGOTA NJ
07603-1634
US
V. Phone/Fax
- Phone: 845-527-8008
- Fax: 201-820-4365
- Phone: 845-527-8008
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
SAMIR
AZIZ
Title or Position: OWNER /DIRECTOR
Credential: MR.
Phone: 845-527-8008