Healthcare Provider Details

I. General information

NPI: 1770686917
Provider Name (Legal Business Name): COUNTY PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 SUNSET RIDGE RD SUITE 250
NEW PALTZ NY
12561-1036
US

IV. Provider business mailing address

40 SUNSET RIDGE RD SUITE 250
NEW PALTZ NY
12561-1036
US

V. Phone/Fax

Practice location:
  • Phone: 845-256-0820
  • Fax: 845-256-9028
Mailing address:
  • Phone: 845-256-0820
  • Fax: 845-256-9028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number012834
License Number StateNY

VIII. Authorized Official

Name: MR. PATRICK CLOUGH
Title or Position: THERAPIST
Credential: P.T., C.H.T
Phone: 845-256-0820