Provider Demographics
NPI:1124025788
Name:RYE PHYSICAL THERAPY & REHABILITATION, PC
Entity Type:Organization
Organization Name:RYE PHYSICAL THERAPY & REHABILITATION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-921-6061
Mailing Address - Street 1:411 THEODORE FREMD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-1410
Mailing Address - Country:US
Mailing Address - Phone:914-921-6061
Mailing Address - Fax:914-921-6075
Practice Address - Street 1:411 THEODORE FREMD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1410
Practice Address - Country:US
Practice Address - Phone:914-921-6061
Practice Address - Fax:914-921-6075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012761225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ1WDY1Medicare PIN