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General NPI Number Information
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NPI Number | 1184005183
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Entity Type | Organization
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Legal Business Name | INTEGRATE NYC PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 240 E 56TH ST 4W
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City | NEW YORK
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State | NY
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Zip | 10022-3755
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Country | US
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Telephone | 212-256-0302
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Fax | 646-304-8434
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Provider Business Mailing Address
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Address Line | 240 E 56TH ST 4W
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City | NEW YORK
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State | NY
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Zip | 10022-3755
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Country | US
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Telephone | 212-256-0302
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Fax | 646-304-8434
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MR. COLIN PAUL O'BANION
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Credential | DPT
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Telephone | 212-256-0302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 0286921
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License Number State | NY
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