Healthcare Provider Details

I. General information

NPI: 1285798652
Provider Name (Legal Business Name): ROCKLAND PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 02/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 EXECUTIVE BLVD SUITE 204A
SUFFERN NY
10901-4164
US

IV. Provider business mailing address

2 EXECUTIVE BLVD SUITE 204A
SUFFERN NY
10901-4164
US

V. Phone/Fax

Practice location:
  • Phone: 845-357-5686
  • Fax: 845-357-3897
Mailing address:
  • Phone: 845-357-5686
  • Fax: 845-357-3897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. LYNDA MESSINA ANGUS
Title or Position: CLINICAL DIRECTOR
Credential: PT
Phone: 845-357-5686