Healthcare Provider Details

I. General information

NPI: 1336850643
Provider Name (Legal Business Name): SORA PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2022
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W RED OAK LN
WHITE PLAINS NY
10604-3601
US

IV. Provider business mailing address

25 W RED OAK LN
WHITE PLAINS NY
10604-3601
US

V. Phone/Fax

Practice location:
  • Phone: 914-328-3750
  • Fax: 914-328-6945
Mailing address:
  • Phone: 914-328-3750
  • Fax: 914-328-6945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS PATRICK MCCAFFREY JR.
Title or Position: OWNER/ PHYSICAL THERAPIST
Credential:
Phone: 914-328-3750