Healthcare Provider Details

I. General information

NPI: 1871982231
Provider Name (Legal Business Name): PROFITNESS PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2015
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 E 84TH ST 2ND FLOOR
NEW YORK NY
10028-2000
US

IV. Provider business mailing address

171 E 84TH ST 2ND FLOOR
NEW YORK NY
10028-2000
US

V. Phone/Fax

Practice location:
  • Phone: 212-327-0600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number62037912
License Number StateNY

VIII. Authorized Official

Name: KINNYL NUNEZ
Title or Position: MANAGER
Credential:
Phone: 212-327-0600