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General NPI Number Information
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NPI Number | 1437386414
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Entity Type | Organization
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Legal Business Name | ORD PHYSIATRY, PC
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 1 COMMONS DR
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City | LAKE KATRINE
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State | NY
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Zip | 12449-5149
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Country | US
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Telephone | 845-521-1542
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Fax |
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Provider Business Mailing Address
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Address Line | 983 HAVERSTRAW RD
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City | SUFFERN
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State | NY
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Zip | 10901-2200
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Country | US
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Telephone | 845-521-1542
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Fax | 845-354-4808
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | SERENE THORNTON
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Credential |
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Telephone | 845-521-1542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 148797
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License Number State | NY
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