Healthcare Provider Details

I. General information

NPI: 1760999668
Provider Name (Legal Business Name): ORCHARD PARK PROGRESSIVE PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086B UNION RD
WEST SENECA NY
14224-3449
US

IV. Provider business mailing address

1086B UNION RD
WEST SENECA NY
14224-3449
US

V. Phone/Fax

Practice location:
  • Phone: 716-608-6730
  • Fax: 716-608-6445
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: PHILIP MANISCALCO
Title or Position: PT/OWNER
Credential: PT
Phone: 716-830-4186