Provider Demographics
NPI:1164542486
Name:CAMILLUS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:CAMILLUS PHYSICAL THERAPY
Other - Org Name:CNY PHYSICAL THERAPY AQUATIC CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-452-5580
Mailing Address - Street 1:5700 WEST GENESEE STREET
Mailing Address - Street 2:SUITE 2S
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031
Mailing Address - Country:US
Mailing Address - Phone:315-452-5580
Mailing Address - Fax:315-452-5303
Practice Address - Street 1:5700 W GENESEE ST
Practice Address - Street 2:SUITE 2S
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-3200
Practice Address - Country:US
Practice Address - Phone:315-452-5580
Practice Address - Fax:315-452-5303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy