Provider Demographics
NPI:1275399503
Name:HOME PHYSIO CORP
Entity Type:Organization
Organization Name:HOME PHYSIO CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CHILLIANIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-998-6328
Mailing Address - Street 1:25 ROBINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-2717
Mailing Address - Country:US
Mailing Address - Phone:516-998-6328
Mailing Address - Fax:
Practice Address - Street 1:25 ROBINWOOD DR
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-2717
Practice Address - Country:US
Practice Address - Phone:516-998-6328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty