Provider Demographics
NPI:1144563990
Name:CLUTCH PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:CLUTCH PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, FAFS
Authorized Official - Phone:646-238-9199
Mailing Address - Street 1:250 W 85TH ST APT 10C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3219
Mailing Address - Country:US
Mailing Address - Phone:212-203-6802
Mailing Address - Fax:
Practice Address - Street 1:244 E 84TH ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2904
Practice Address - Country:US
Practice Address - Phone:212-203-6802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-30
Last Update Date:2013-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032171-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1740507045OtherMEDICARE NPI FOR ME/OWNER/FOUNDER