Provider Demographics
NPI:1164284675
Name:ATLAS PEAK PHYSICAL THERAPY P.L.L.C.
Entity Type:Organization
Organization Name:ATLAS PEAK PHYSICAL THERAPY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ATHANASATOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:914-924-4129
Mailing Address - Street 1:16 CLOVEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1304
Mailing Address - Country:US
Mailing Address - Phone:914-924-4129
Mailing Address - Fax:
Practice Address - Street 1:16 CLOVEBROOK RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1304
Practice Address - Country:US
Practice Address - Phone:914-924-4129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty