Provider Demographics
NPI:1164765988
Name:ABSOLUTE PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:ABSOLUTE PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-783-0286
Mailing Address - Street 1:1510 CENTRAL AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5069
Mailing Address - Country:US
Mailing Address - Phone:518-783-0286
Mailing Address - Fax:518-690-7129
Practice Address - Street 1:1510 CENTRAL AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5069
Practice Address - Country:US
Practice Address - Phone:518-783-0286
Practice Address - Fax:518-690-7129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018048-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty