MEDICARE: PHYSICAL THERAPY ASSOCIATES OF SCHENECTADY, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1124101977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY ASSOCIATES OF SCHENECTADY, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 387
Second Line	:
City	:	WEST SAND LAKE
State	:	NY
Zip	:	12196-0387
Country	:	US
Telephone Number	:	518-374-1744
Fax Number	:	518-374-1774

Provider Business Practice Location Address
First Line	:	43 MALL
Second Line	:
City	:	WEST SAND LAKE
State	:	NY
Zip	:	12196-0387
Country	:	US
Telephone Number	:	518-374-1744
Fax Number	:	518-374-1774

Authorized Official
Title or Position	:	PHYSICAL THERAPIST OWNER
Name	:	THOMAS COONEY
Credential	:	MS, PT
Telephone Number	:	518-674-1744

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/22/2020

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