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General NPI Number Information
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NPI Number | 1205633815
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Entity Type | Organization
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Legal Business Name | UPSTATE PHYSICAL THERAPY P.C.
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Dates
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Enumeration Date | 03/01/2025
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Last Update Date | 03/01/2025
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Provider Practice Location Address
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Address Line | 3188 ROUTE 9W STE B
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City | NEW WINDSOR
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State | NY
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Zip | 12553-6754
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Country | US
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Telephone | 845-310-4615
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Fax | 845-346-4616
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Provider Business Mailing Address
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Address Line | 3188 ROUTE 9W STE B
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City | NEW WINDSOR
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State | NY
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Zip | 12553-6754
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Country | US
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Telephone | 845-310-4615
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Fax | 845-346-4616
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Authorized Official
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Title or Position | OWNER
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Name | MR. KISHORE KANDURI
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Credential | PT
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Telephone | 845-310-4615
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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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