Provider Demographics
NPI:1144820762
Name:PHOENIX PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:PHOENIX PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARANTZAZU
Authorized Official - Middle Name:GARATE
Authorized Official - Last Name:CIOCE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:813-362-1306
Mailing Address - Street 1:4 CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:OLD TAPPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-7247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:337 BLAISDELL RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-2508
Practice Address - Country:US
Practice Address - Phone:914-340-4623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy