Provider Demographics
NPI:1114469376
Name:POWER OF MOVEMENT PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:POWER OF MOVEMENT PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODERICK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:914-364-0504
Mailing Address - Street 1:11 STONE HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-2678
Mailing Address - Country:US
Mailing Address - Phone:914-364-0504
Mailing Address - Fax:914-828-0100
Practice Address - Street 1:2900 WESTCHESTER AVENUE
Practice Address - Street 2:SUITE 108
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2551
Practice Address - Country:US
Practice Address - Phone:914-364-0504
Practice Address - Fax:914-828-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025723174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty