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General NPI Number Information
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NPI Number | 1073903084
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Entity Type | Organization
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Legal Business Name | PERFORMANCE PHYSICAL THERAPY OF NEW YORK PLLC
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 115 W 45TH ST SUITE 301
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City | NEW YORK
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State | NY
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Zip | 10036-4005
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Country | US
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Telephone | 212-300-5545
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Fax | 212-300-5495
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Provider Business Mailing Address
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Address Line | 333 POST RD W
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City | WESTPORT
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State | CT
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Zip | 06880-4701
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Country | US
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Telephone | 203-422-0679
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MICHAEL COOK
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Credential |
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Telephone | 201-264-6983
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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 |
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License Number State |
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