Provider Demographics
NPI:1093824021
Name:WHITNEY POINT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:WHITNEY POINT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-656-8718
Mailing Address - Street 1:2663 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WHITNEY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:13862
Mailing Address - Country:US
Mailing Address - Phone:607-692-4420
Mailing Address - Fax:607-692-4415
Practice Address - Street 1:2663 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WHITNEY POINT
Practice Address - State:NY
Practice Address - Zip Code:13862-0253
Practice Address - Country:US
Practice Address - Phone:607-692-4420
Practice Address - Fax:607-692-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
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
NYAA1298Medicare ID - Type Unspecified