MEDICARE: THE FITNESS GROUP

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	025701-1	NY

General Provider Information

NPI Number	:	1528200649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FITNESS GROUP

Provider Business Mailing Address
First Line	:	485 CENTRAL PARK W
Second Line	:	APT.#3F
City	:	NEW YORK
State	:	NY
Zip	:	10025-3322
Country	:	US
Telephone Number	:	917-291-8656
Fax Number	:

Provider Business Practice Location Address
First Line	:	485 CENTRAL PARK W
Second Line	:	APT.#3F
City	:	NEW YORK
State	:	NY
Zip	:	10025-3322
Country	:	US
Telephone Number	:	917-291-8656
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KYLE WARNER
Credential	:
Telephone Number	:	917-291-8656

Provider Enumeration Date	:	04/03/2009
Last Update Date	:	04/03/2009

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Directions to “THE FITNESS GROUP ” Practice Location

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