Provider Demographics
NPI:1003543232
Name:GERIGYMLLC
Entity Type:Organization
Organization Name:GERIGYMLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTHOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:KACHANATHU PHILIP
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-445-4935
Mailing Address - Street 1:2147 4TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1853
Mailing Address - Country:US
Mailing Address - Phone:516-445-4935
Mailing Address - Fax:
Practice Address - Street 1:2147 4TH ST
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1853
Practice Address - Country:US
Practice Address - Phone:516-445-4935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty