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NPI Code Detail

MEDICARE: SENECA PHYSICAL THERAPY OF THE FINGER LAKES, PC

MEDICARE: SENECA PHYSICAL THERAPY OF THE FINGER LAKES, PC
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
1225100000XPhysical Therapist018951-1NY

General Provider Information

NPI Number : 1174672950
Entity Type Code : Organization
Provider Name (Legal Business Name) : SENECA PHYSICAL THERAPY OF THE FINGER LAKES, PC
Provider Business Mailing Address
First Line : 609 N FRANKLIN ST
Second Line :
City : WATKINS GLEN
State : NY
Zip : 14891-1302
Country : US
Telephone Number : 607-535-7475
Fax Number :
Provider Business Practice Location Address
First Line : 609 N FRANKLIN ST
Second Line :
City : WATKINS GLEN
State : NY
Zip : 14891-1302
Country : US
Telephone Number : 607-535-7475
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. AMANDA SMITH-SOCARIS
Credential : PT, MS, OCS, CSCS
Telephone Number : 607-535-7475
Provider Enumeration Date : 01/09/2007
Last Update Date : 08/22/2020

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