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General NPI Number Information
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NPI Number | 1063554806
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Entity Type | Organization
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Legal Business Name | PIVOTAL PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 30 EAST 60TH ST., SUITE 1006
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City | NEW YORK
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State | NY
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Zip | 10022
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Country | US
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Telephone | 212-317-9798
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Fax | 212-245-5935
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Provider Business Mailing Address
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Address Line | 30 EAST 60TH ST., SUITE 1006
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City | NEW YORK
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State | NY
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Zip | 10022
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Country | US
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Telephone | 212-317-9798
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Fax | 212-245-5935
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR
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Name | MS. EVELINE ANNA ERNI
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Credential | PT
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Telephone | 212-317-9798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0103911
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License Number State | NY
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