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General NPI Number Information
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NPI Number | 1558914796
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Entity Type | Organization
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Legal Business Name | THRIVE THERAPY LLC
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Dates
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Enumeration Date | 07/17/2019
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 918 JAMES ST
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City | SYRACUSE
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State | NY
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Zip | 13203-2500
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Country | US
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Telephone | 646-924-7211
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Fax |
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Provider Business Mailing Address
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Address Line | 12 SPENCER ST
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City | BROOKLYN
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State | NY
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Zip | 11205-1891
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Country | US
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Telephone | 646-924-7211
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MENACHEM TAUBER
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Credential |
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Telephone | 646-924-7211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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