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General NPI Number Information
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NPI Number | 1174757389
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Entity Type | Individual
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Provider Name | ROBERT THOMAS LEMYRE DPT
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Gender | Male
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Dates
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Enumeration Date | 05/04/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 444 S FULTON AVE XPERIENCEPT/ACTIVE FIT GRD FLR
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City | MOUNT VERNON
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State | NY
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Zip | 10553-1718
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Country | US
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Telephone | 914-882-0830
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Fax | 914-479-0039
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Provider Business Mailing Address
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Address Line | 16 JOHN R ALBANESE PLACE STOREFRONT # 18
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City | EASTCHESTER
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State | NY
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Zip | 10709-4402
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Country | US
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Telephone | 914-882-0830
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Fax | 914-479-0039
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 031217
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License Number State | NY
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