Healthcare Provider Details

I. General information

NPI: 1295050268
Provider Name (Legal Business Name): SHAIR HOME CARE PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 06/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

473 FDR DR STOREFRONT
NEW YORK NY
10002-2024
US

IV. Provider business mailing address

473 FDR DR STOREFRONT
NEW YORK NY
10002-2024
US

V. Phone/Fax

Practice location:
  • Phone: 212-475-2000
  • Fax:
Mailing address:
  • Phone: 212-475-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number015866-1
License Number StateNY

VIII. Authorized Official

Name: MS. SUZANNE SHAIR
Title or Position: OWNER
Credential: PT
Phone: 212-475-2000