Provider Demographics
NPI:1275077703
Name:STRAM ACUPUNCTURE AND PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:STRAM ACUPUNCTURE AND PHYSICAL THERAPY PLLC
Other - Org Name:RUNNER CLINIC NYC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAM
Authorized Official - Suffix:
Authorized Official - Credentials:PT, LAC
Authorized Official - Phone:917-484-0887
Mailing Address - Street 1:55 W 39TH ST
Mailing Address - Street 2:SUITE 708
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3803
Mailing Address - Country:US
Mailing Address - Phone:917-484-0887
Mailing Address - Fax:
Practice Address - Street 1:55 W 39TH ST
Practice Address - Street 2:SUITE 708
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3803
Practice Address - Country:US
Practice Address - Phone:917-484-0887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003039171100000X
NY020372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty