Healthcare Provider Details

I. General information

NPI: 1124101977
Provider Name (Legal Business Name): PHYSICAL THERAPY ASSOCIATES OF SCHENECTADY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 MALL
WEST SAND LAKE NY
12196-0387
US

IV. Provider business mailing address

PO BOX 387
WEST SAND LAKE NY
12196-0387
US

V. Phone/Fax

Practice location:
  • Phone: 518-374-1744
  • Fax: 518-374-1774
Mailing address:
  • Phone: 518-374-1744
  • Fax: 518-374-1774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: THOMAS COONEY
Title or Position: PHYSICAL THERAPIST OWNER
Credential: MS, PT
Phone: 518-674-1744