MEDICARE: DR. ROBERT THOMAS LEMYRE DPT

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	031217	NY

General Provider Information

NPI Number	:	1174757389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT THOMAS LEMYRE DPT

Provider Business Mailing Address
First Line	:	16 JOHN R ALBANESE PLACE
Second Line	:	STOREFRONT # 18
City	:	EASTCHESTER
State	:	NY
Zip	:	10709-4402
Country	:	US
Telephone Number	:	914-882-0830
Fax Number	:	914-479-0039

Provider Business Practice Location Address
First Line	:	444 S FULTON AVE
Second Line	:	XPERIENCEPT/ACTIVE FIT GRD FLR
City	:	MOUNT VERNON
State	:	NY
Zip	:	10553-1718
Country	:	US
Telephone Number	:	914-882-0830
Fax Number	:	914-479-0039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	07/21/2022

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