Healthcare Provider Details

I. General information

NPI: 1598833220
Provider Name (Legal Business Name): PULMONARY WELLNESS REHABILITATION PTPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 W 38TH ST 4TH FLOOR
NEW YORK NY
10018-6262
US

IV. Provider business mailing address

22 W 38TH ST 4TH FLOOR
NEW YORK NY
10018-6262
US

V. Phone/Fax

Practice location:
  • Phone: 212-921-0214
  • Fax: 212-921-0217
Mailing address:
  • Phone: 212-921-0214
  • Fax: 212-921-0217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number012954
License Number StateNY

VIII. Authorized Official

Name: DR. NOAH GREENSPAN
Title or Position: PROGRAM DIRECTOR
Credential: DPT
Phone: 212-921-0214