Provider Demographics
NPI:1114986965
Name:PARAMOUNT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PARAMOUNT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESPERITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-855-0857
Mailing Address - Street 1:248 EAST 31STREET
Mailing Address - Street 2:APT # 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9710
Mailing Address - Country:US
Mailing Address - Phone:212-855-0857
Mailing Address - Fax:212-428-1815
Practice Address - Street 1:248 E 31ST ST
Practice Address - Street 2:APT # 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9710
Practice Address - Country:US
Practice Address - Phone:212-855-0857
Practice Address - Fax:212-428-1815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty