Provider Demographics
NPI:1114358173
Name:SPECTRUM HOME PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:SPECTRUM HOME PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SAJANI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMPHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:845-393-1204
Mailing Address - Street 1:12 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10926-3205
Mailing Address - Country:US
Mailing Address - Phone:845-393-1204
Mailing Address - Fax:845-238-5688
Practice Address - Street 1:12 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:NY
Practice Address - Zip Code:10926-3205
Practice Address - Country:US
Practice Address - Phone:845-393-1204
Practice Address - Fax:845-238-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031716-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty