Provider Demographics
NPI:1154079309
Name:STEP-UP NY PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:STEP-UP NY PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO/PT
Authorized Official - Prefix:DR
Authorized Official - First Name:NINO POMPEYO ROCCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BORJA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:908-922-5762
Mailing Address - Street 1:245 WOODFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2528
Mailing Address - Country:US
Mailing Address - Phone:908-922-5762
Mailing Address - Fax:
Practice Address - Street 1:6241 WOODHAVEN BLVD BSMT
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3731
Practice Address - Country:US
Practice Address - Phone:929-607-3271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty