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General NPI Number Information
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NPI Number | 1205073418
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL SPORTSCARE OF NEW YORK, LLC
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 102 FAIRVIEW PK DR
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City | ELMSFORD
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State | NY
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Zip | 10523-1518
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Country | US
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Telephone | 914-345-6080
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Fax | 914-345-6083
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Provider Business Mailing Address
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Address Line | 102 FAIRVIEW PK DR
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City | ELMSFORD
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State | NY
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Zip | 10523-1518
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Country | US
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Telephone | 914-345-6080
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Fax | 914-345-6083
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY KATZ
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Credential | PT
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Telephone | 443-506-8272
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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 | NY
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