Healthcare Provider Details

I. General information

NPI: 1336330612
Provider Name (Legal Business Name): CENTER FOR PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 10/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DELAVERGNE AVE
WAPPINGERS FALLS NY
12590-1202
US

IV. Provider business mailing address

2 DELAVERGNE AVE
WAPPINGERS FALLS NY
12590-1202
US

V. Phone/Fax

Practice location:
  • Phone: 845-297-4789
  • Fax: 845-297-8596
Mailing address:
  • Phone: 845-297-4789
  • Fax: 845-297-8596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTIAN D. CAMPILII
Title or Position: CO-OWNER/PHYSICAL THERAPIST
Credential: P.T.
Phone: 845-297-4789