MEDICARE: ELITE PERFORMANCE PHYSICAL THERAPY OF WESTCHESTER 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
1	225100000X	Physical Therapist		NY

General Provider Information

NPI Number	:	1326355058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE PERFORMANCE PHYSICAL THERAPY OF WESTCHESTER PC

Provider Business Mailing Address
First Line	:	PO BOX 179
Second Line	:
City	:	SOMERS
State	:	NY
Zip	:	10589-0179
Country	:	US
Telephone Number	:	917-476-2164
Fax Number	:	914-245-3905

Provider Business Practice Location Address
First Line	:	175 E MAIN ST STE 204
Second Line	:
City	:	MOUNT KISCO
State	:	NY
Zip	:	10549-2973
Country	:	US
Telephone Number	:	917-476-2164
Fax Number	:	914-245-3905

Authorized Official
Title or Position	:	PRESIDENT / PHYSICAL THERAPIST
Name	:	TINA M SFERRA
Credential	:	MSPT
Telephone Number	:	917-476-2164

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	07/21/2022

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