Healthcare Provider Details

I. General information

NPI: 1295659290
Provider Name (Legal Business Name): KASIM THOMAS PT,DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 YONKERS AVE
YONKERS NY
10704-3052
US

IV. Provider business mailing address

3427 OLINVILLE AVE
BRONX NY
10467-5612
US

V. Phone/Fax

Practice location:
  • Phone: 914-423-3750
  • Fax: 914-423-3664
Mailing address:
  • Phone: 917-574-1791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number055645
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: