MEDICARE: NEW YORK PHYSICAL THERAPY MANAGEMENT, 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	006893-1	NY

General Provider Information

NPI Number	:	1548504046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW YORK PHYSICAL THERAPY MANAGEMENT, PC

Provider Business Mailing Address
First Line	:	1 HOLLOW LN STE 214
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1215
Country	:	US
Telephone Number	:	516-482-0100
Fax Number	:	516-482-0172

Provider Business Practice Location Address
First Line	:	1 HOLLOW LN STE 214
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1215
Country	:	US
Telephone Number	:	516-482-0100
Fax Number	:	516-482-0172

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ATTILIO S. PENSAVALLE
Credential	:	PT, DPT
Telephone Number	:	516-482-0100

Provider Enumeration Date	:	11/21/2012
Last Update Date	:	01/15/2026

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