MEDICARE: FULTON THERAPY SERVICES 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1629231618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FULTON THERAPY SERVICES PC

Provider Business Mailing Address
First Line	:	444 S FULTON AVE
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10553-1718
Country	:	US
Telephone Number	:	914-723-4900
Fax Number	:	914-723-7893

Provider Business Practice Location Address
First Line	:	444 S FULTON AVE
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10553-1718
Country	:	US
Telephone Number	:	914-723-4900
Fax Number	:	914-723-7893

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. DAVID ALBEN
Credential	:
Telephone Number	:	914-723-4900

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	07/09/2008

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