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General NPI Number Information
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NPI Number | 1437303518
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Entity Type | Organization
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Legal Business Name | VERNON REHAB & PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 11/16/2008
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 2 STRAWTOWN RD SUITE 4,5
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City | WEST NYACK
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State | NY
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Zip | 10994-3514
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Country | US
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Telephone | 845-358-0019
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Fax | 845-358-3921
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Provider Business Mailing Address
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Address Line | 2 STRAWTOWN RD SUITE 4, 5
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City | WEST NYACK
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State | NY
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Zip | 10994-3514
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Country | US
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Telephone | 845-358-0019
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Fax | 845-358-3921
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAJAN AUGUSTINE
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Credential | PHYSICAL THERAPIST
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Telephone | 914-843-4155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 021666-1
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License Number State | NY
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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 | 021666-1
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License Number State | NY
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