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General NPI Number Information
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NPI Number | 1417146614
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Entity Type | Organization
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Legal Business Name | NY SPORTS AND SPINAL PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 7 POPHAM RD SUITE 302
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City | SCARSDALE
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State | NY
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Zip | 10583-3709
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Country | US
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Telephone | 914-396-4273
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Fax | 914-779-3152
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Provider Business Mailing Address
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Address Line | 71 GLEN ROAD
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City | YONKERS
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State | NY
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Zip | 10704-3617
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Country | US
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Telephone | 914-396-4273
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Fax | 914-779-3152
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Authorized Official
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Title or Position | PRINCIPAL OFFICER
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Name | KARN SANTIKUL
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Credential | DPT
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Telephone | 914-396-4273
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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 | 026668-1
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License Number State | NY
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