Provider Demographics
NPI:1093755852
Name:NEW ROCHELLE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:NEW ROCHELLE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:LILEIKA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-632-1100
Mailing Address - Street 1:1 RADISSON PLAZA
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5766
Mailing Address - Country:US
Mailing Address - Phone:914-632-1100
Mailing Address - Fax:914-632-1182
Practice Address - Street 1:1 RADISSON PLAZA
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5766
Practice Address - Country:US
Practice Address - Phone:914-632-1100
Practice Address - Fax:914-632-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004246-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCJ6956OtherRAILROAD MEDICARE GROUP #
NY0028601OtherAETNA ORTHO GROUP #
NY2029948OtherAETNA HMO GROUP #
NY109385600OtherUS DOL GROUP #
NY0028601OtherUS FAMILY ORTHO FACILIT #
NYA402195OtherOXFORD FACILITY #
NY128985OtherMPN FACILITY #
NY28601OtherORTHONET FACILITY #
NJ5581006OtherAETNA PPO GROUP #
NY0028601OtherAETNA ORTHO GROUP #
NY0028601OtherUS FAMILY ORTHO FACILIT #