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General NPI Number Information
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NPI Number | 1386677920
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Entity Type | Organization
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Legal Business Name | PERFORMING ARTS PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 13 CEDAR ST
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City | HASTINGS ON HUDSON
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State | NY
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Zip | 10706-3905
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Country | US
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Telephone | 212-245-7278
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Fax | 212-245-7461
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Provider Business Mailing Address
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Address Line | 13 CEDAR ST
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City | HASTINGS ON HUDSON
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State | NY
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Zip | 10706-3905
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Country | US
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Telephone | 212-245-7278
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Fax | 212-245-7461
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Authorized Official
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Title or Position | OWNER
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Name | MR. SEAN PADRIC GALLAGHER
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Credential | PT
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Telephone | 212-245-7178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 009366-1
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License Number State | NY
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