Healthcare Provider Details

I. General information

NPI: 1053564229
Provider Name (Legal Business Name): THERESE MAUREEN ROWCROFT P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 ROUTE 23B
SOUTH CAIRO NY
12482-1220
US

IV. Provider business mailing address

15 BARTOW ST
CATSKILL NY
12414-1046
US

V. Phone/Fax

Practice location:
  • Phone: 518-522-8382
  • Fax:
Mailing address:
  • Phone: 518-943-3250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4203
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number4203
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: