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General NPI Number Information
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NPI Number | 1588642201
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Entity Type | Organization
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Legal Business Name | ST. MARKS PHYSICAL THERAPY, P.C
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 07/24/2012
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Provider Practice Location Address
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Address Line | 800 2ND AVENUE SUITE 802
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 212-600-9299
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Fax | 718-775-3419
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Provider Business Mailing Address
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Address Line | 800 2ND AVENUE SUITE 802
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 212-600-9299
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Fax | 718-775-3419
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Authorized Official
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Title or Position | PRESIDENT/CEO/DPT
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Name | DR. MICHAEL M MORGANN
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Credential | DPT
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Telephone | 212-600-9299
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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 | 022691
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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 | 022691
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License Number State | NY
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