Provider Demographics
NPI:1083064554
Name:DAVID F ANDERSON, PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:DAVID F ANDERSON, PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYAICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:FARRELL
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-661-0222
Mailing Address - Street 1:14907 SANFORD AVE
Mailing Address - Street 2:#1A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14907 SANFORD AVE
Practice Address - Street 2:#1A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1050
Practice Address - Country:US
Practice Address - Phone:347-661-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015229251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health