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General NPI Number Information
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NPI Number | 1104159714
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Entity Type | Organization
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Legal Business Name | STRIDE PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 89 5TH AVE SUITE 1002
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City | NEW YORK
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State | NY
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Zip | 10003-3020
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Country | US
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Telephone | 212-255-6355
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Fax | 212-255-8355
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Provider Business Mailing Address
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Address Line | 89 5TH AVE SUITE 1002
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City | NEW YORK
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State | NY
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Zip | 10003-3020
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Country | US
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Telephone | 212-255-6355
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Fax | 212-255-8355
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JONATHAN A COHEN
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Credential | MSPT
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Telephone | 212-255-6355
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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 | 028061
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License Number State | NY
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