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General NPI Number Information
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NPI Number | 1265184998
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Entity Type | Organization
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Legal Business Name | FIFTH AVENUE PHYSICAL THERAPY AND WELLNESS PC
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 1301 AVENUE OF THE AMERICAS PARAMOUNT WELLNESS / CONCOURSE LEVEL
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City | NEW YORK
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State | NY
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Zip | 10019-6022
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Country | US
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Telephone | 347-507-5877
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Fax | 347-507-5877
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Provider Business Mailing Address
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Address Line | 1301 AVENUE OF THE AMERICAS PARAMOUNT WELLNESS / CONCOURSE LEVEL
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City | NEW YORK
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State | NY
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Zip | 10019-6022
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Country | US
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Telephone | 347-507-5877
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Fax | 347-507-5877
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Authorized Official
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Title or Position | OWNER / PRINCIPAL
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Name | SCOTT A WEISS
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Credential | DPT ATC
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Telephone | 347-507-5877
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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 |
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License Number State |
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Taxonomy #2
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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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