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NPI Code Detail

MEDICARE: SPEAR PHYSICAL AND OCCUPATIONAL THERAPY, LLC

MEDICARE: SPEAR PHYSICAL AND OCCUPATIONAL THERAPY, LLC
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 Therapist

General Provider Information

NPI Number : 1265024236
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPEAR PHYSICAL AND OCCUPATIONAL THERAPY, LLC
Provider Business Mailing Address
First Line : 307 5TH AVENUE
Second Line : FL 6
City : NEW YORK
State : NY
Zip : 10016-6575
Country : US
Telephone Number : 212-759-2282
Fax Number : 212-379-2123
Provider Business Practice Location Address
First Line : 630 3RD AVENUE
Second Line : GROUND FL
City : NEW YORK
State : NY
Zip : 10017-6705
Country : US
Telephone Number : 212-759-2282
Fax Number :
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : ALLISON RIVERA
Credential :
Telephone Number : 212-759-2282
Provider Enumeration Date : 02/10/2021
Last Update Date : 02/10/2021

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