Provider Demographics
NPI:1265505358
Name:NORTHERN WESTCHESTER PHYSCIAL & OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:NORTHERN WESTCHESTER PHYSCIAL & OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-241-0106
Mailing Address - Street 1:40 RADIO CIRCLE DR STE 2
Mailing Address - Street 2:PO BOX 622
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2625
Mailing Address - Country:US
Mailing Address - Phone:914-241-0106
Mailing Address - Fax:914-241-7263
Practice Address - Street 1:40 RADIO CIRCLE DR STE 2
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2625
Practice Address - Country:US
Practice Address - Phone:914-241-0106
Practice Address - Fax:914-241-7263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005599-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ0WSG1Medicare PIN
NY4772960001Medicare NSC