=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013260496
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A HEALTHIER YOU PHYSICAL THERAPY LLP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2012
-----------------------------------------------------
Last Update Date | 08/22/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27 LESLIE PL
-----------------------------------------------------
City | NEW ROCHELLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10804-1214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-458-2249
-----------------------------------------------------
Fax | 914-885-1072
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 333 MAMARONECK AVE #331
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10605-1440
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-458-2249
-----------------------------------------------------
Fax | 914-885-1072
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | MS. DELALI ABLA GOKA
-----------------------------------------------------
Credential | PT,DPT
-----------------------------------------------------
Telephone | 914-458-2249
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 026319
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------