Provider Demographics
NPI:1275651135
Name:EXPERT PHYSICAL MEDICINE & REHABILITATION, PC
Entity Type:Organization
Organization Name:EXPERT PHYSICAL MEDICINE & REHABILITATION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:914-242-3500
Mailing Address - Street 1:103 S BEDFORD RD
Mailing Address - Street 2:STE 206
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3440
Mailing Address - Country:US
Mailing Address - Phone:914-242-3500
Mailing Address - Fax:914-242-7036
Practice Address - Street 1:103 S BEDFORD RD
Practice Address - Street 2:STE 206
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3440
Practice Address - Country:US
Practice Address - Phone:914-242-3500
Practice Address - Fax:914-242-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164146208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW30731Medicare ID - Type UnspecifiedMEDICARE GROUP ID