Provider Demographics
NPI:1013208024
Name:FLEMING PHYSICAL THERAPY CONSULTANT PC
Entity Type:Organization
Organization Name:FLEMING PHYSICAL THERAPY CONSULTANT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-346-0605
Mailing Address - Street 1:2 GUY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-4117
Mailing Address - Country:US
Mailing Address - Phone:518-212-6291
Mailing Address - Fax:
Practice Address - Street 1:2 GUY PARK AVE
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4117
Practice Address - Country:US
Practice Address - Phone:518-212-6291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty