Provider Demographics
NPI:1245200518
Name:MORIARTY PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:MORIARTY PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIARTY
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT
Authorized Official - Phone:845-454-4137
Mailing Address - Street 1:301 MANCHESTER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2587
Mailing Address - Country:US
Mailing Address - Phone:845-454-4137
Mailing Address - Fax:845-454-6457
Practice Address - Street 1:301 MANCHESTER RD
Practice Address - Street 2:STE 101
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2587
Practice Address - Country:US
Practice Address - Phone:845-454-4137
Practice Address - Fax:845-454-6457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6348OtherCDPHP
NY200055181OtherMVP
NY6348OtherCDPHP