Provider Demographics
NPI:1225330392
Name:SALT CITY PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:SALT CITY PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CARDI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:315-200-1800
Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2856
Mailing Address - Country:US
Mailing Address - Phone:315-472-1488
Mailing Address - Fax:315-476-1792
Practice Address - Street 1:5795 WIDEWATERS PARKWAY
Practice Address - Street 2:SUITE 1A
Practice Address - City:DEWITT
Practice Address - State:NY
Practice Address - Zip Code:13214-1846
Practice Address - Country:US
Practice Address - Phone:315-200-1800
Practice Address - Fax:315-200-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021825261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy