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General NPI Number Information
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NPI Number | 1457947673
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Entity Type | Organization
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Legal Business Name | TESSY PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 12/13/2020
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Last Update Date | 12/13/2020
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Provider Practice Location Address
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Address Line | 58 MARYCREST RD
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City | WEST NYACK
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State | NY
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Zip | 10994-2444
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Country | US
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Telephone | 586-350-9881
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Fax |
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Provider Business Mailing Address
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Address Line | 58 MARYCREST RD
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City | WEST NYACK
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State | NY
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Zip | 10994-2444
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Country | US
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Telephone | 586-350-9881
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TESSY OOMMEN
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Credential | PT, DPT, MBA
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Telephone | 586-350-9881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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