Provider Demographics
NPI:1053647917
Name:FORTIUS PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:FORTIUS PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:TRAKIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPT
Authorized Official - Phone:212-757-7110
Mailing Address - Street 1:850 7TH AVE
Mailing Address - Street 2:SUITE 905
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5230
Mailing Address - Country:US
Mailing Address - Phone:212-757-7110
Mailing Address - Fax:212-757-7333
Practice Address - Street 1:850 7TH AVE
Practice Address - Street 2:SUITE 905
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5230
Practice Address - Country:US
Practice Address - Phone:212-757-7110
Practice Address - Fax:212-757-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027259-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty