Provider Demographics
NPI:1083664700
Name:MICHAEL D. WOOD, PT, PC
Entity Type:Organization
Organization Name:MICHAEL D. WOOD, PT, PC
Other - Org Name:CLIFTON PARK PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-383-2610
Mailing Address - Street 1:4 EMMA LANE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065
Mailing Address - Country:US
Mailing Address - Phone:518-383-2610
Mailing Address - Fax:518-383-8188
Practice Address - Street 1:4 EMMA LANE
Practice Address - Street 2:SUITE 401
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065
Practice Address - Country:US
Practice Address - Phone:518-383-2610
Practice Address - Fax:518-383-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0650Medicare PIN