MEDICARE: SOARING EAGLE PHYSICAL THERAPY 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	0235271	NY

General Provider Information

NPI Number	:	1346285194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOARING EAGLE PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	26 FIREMENS MEMORIAL DR
Second Line	:	SUITE 115
City	:	POMONA
State	:	NY
Zip	:	10970-3553
Country	:	US
Telephone Number	:	800-750-8616
Fax Number	:	845-362-8474

Provider Business Practice Location Address
First Line	:	2051 BALDWIN RD
Second Line	:	SUITE 101
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4047
Country	:	US
Telephone Number	:	800-750-8616
Fax Number	:	845-362-8474

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	MR. ADRIAN FERREIRA
Credential	:	PT
Telephone Number	:	914-302-2190

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	04/15/2022

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