Healthcare Provider Details

I. General information

NPI: 1659621910
Provider Name (Legal Business Name): SNYS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 09/14/2012
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

Practice location:
  • Phone: 212-543-3500
  • Fax:
Mailing address:
  • Phone: 212-543-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAMIR AZIZ
Title or Position: OWNER
Credential: PT
Phone: 212-543-3500