Provider Demographics
NPI:1003118829
Name:IN HOUSE PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:IN HOUSE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BADALAMENTI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-637-4603
Mailing Address - Street 1:112 BIDWELL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3177
Mailing Address - Country:US
Mailing Address - Phone:718-637-4603
Mailing Address - Fax:718-448-8287
Practice Address - Street 1:112 BIDWELL AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3177
Practice Address - Country:US
Practice Address - Phone:718-637-4603
Practice Address - Fax:718-448-8287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17990261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy