Provider Demographics
NPI:1306840905
Name:KURTZ PHYSICAL THERAPY SERVICES, PC
Entity Type:Organization
Organization Name:KURTZ PHYSICAL THERAPY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:D
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:607-336-3111
Mailing Address - Street 1:89 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1537
Mailing Address - Country:US
Mailing Address - Phone:607-336-3111
Mailing Address - Fax:607-336-2311
Practice Address - Street 1:89 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1537
Practice Address - Country:US
Practice Address - Phone:607-336-3111
Practice Address - Fax:607-336-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0097551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01125740Medicaid
NY51657BMedicare ID - Type Unspecified