Healthcare Provider Details

I. General information

NPI: 1477307007
Provider Name (Legal Business Name): BOBBY GEEVARUGHESE PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 CENTRAL PARK AVE APT 5209
SCARSDALE NY
10583-1050
US

IV. Provider business mailing address

508 CENTRAL PARK AVE APT 5209
SCARSDALE NY
10583-1050
US

V. Phone/Fax

Practice location:
  • Phone: 914-202-7022
  • Fax:
Mailing address:
  • Phone: 845-536-7297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BOBBY GEEVARUGHESE
Title or Position: OWNER
Credential:
Phone: 914-202-7022