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General NPI Number Information
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NPI Number | 1578195004
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Entity Type | Organization
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Legal Business Name | FORTIFY PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 129 W 29TH ST FL 2
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City | NEW YORK
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State | NY
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Zip | 10001-5192
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Country | US
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Telephone | 646-822-9461
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Fax |
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Provider Business Mailing Address
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Address Line | 148 COLLEGE PL
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-2506
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Country | US
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Telephone | 973-525-4347
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALICIA FERRIERE
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Credential | DPT
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Telephone | 973-525-4347
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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 |
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License Number State |
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