Provider Demographics
NPI:1275721417
Name:PARKVIEW CHIROPRACTIC & PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:PARKVIEW CHIROPRACTIC & PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:ALISE
Authorized Official - Last Name:DELLOVA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-993-3350
Mailing Address - Street 1:2 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2309
Mailing Address - Country:US
Mailing Address - Phone:914-993-3350
Mailing Address - Fax:914-831-0640
Practice Address - Street 1:2 N BROADWAY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2309
Practice Address - Country:US
Practice Address - Phone:914-993-3350
Practice Address - Fax:914-831-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0241071261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQN4421Medicare UPIN