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General NPI Number Information
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NPI Number | 1407726425
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Entity Type | Organization
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Legal Business Name | HENNESSY PTA PLLC
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 226 E 54TH ST STE 501
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City | NEW YORK
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State | NY
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Zip | 10022-4854
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Country | US
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Telephone | 917-848-3594
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Fax | 917-848-3594
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Provider Business Mailing Address
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Address Line | 3215 30TH ST APT B45
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City | ASTORIA
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State | NY
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Zip | 11106-2978
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Country | US
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Telephone | 917-848-3594
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Fax | 917-848-3594
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Authorized Official
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Title or Position | OWNER
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Name | ANN MARIE HENNESSY
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Credential | PTA
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Telephone | 917-848-3594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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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 | 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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