Provider Demographics
NPI:1073530739
Name:VANBEVEREN AND YANKOWITZ PHYSICAL THERAPISTS, PC
Entity Type:Organization
Organization Name:VANBEVEREN AND YANKOWITZ PHYSICAL THERAPISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN-PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-468-2726
Mailing Address - Street 1:2105 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-1656
Mailing Address - Country:US
Mailing Address - Phone:315-468-2726
Mailing Address - Fax:315-487-0048
Practice Address - Street 1:2105 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13219-1656
Practice Address - Country:US
Practice Address - Phone:315-468-2726
Practice Address - Fax:315-487-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0826Medicare ID - Type Unspecified