Healthcare Provider Details
I. General information
NPI: 1497372411
Provider Name (Legal Business Name): FYSIOPLUS ON DEMAND
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/26/2020
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
39 FACTORY ST PH
WARWICK NY
10990-1444
US
IV. Provider business mailing address
39 FACTORY ST PH
WARWICK NY
10990-1444
US
V. Phone/Fax
- Phone: 201-293-0753
- Fax: 609-435-1234
- Phone: 201-293-0753
- Fax: 609-435-1234
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MANUEL
ANGEL
ARRUFFAT
Title or Position: OWNER
Credential: PT DPT
Phone: 201-293-0753