Provider Demographics
NPI:1316556939
Name:EBY PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:EBY PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:EBY
Authorized Official - Suffix:
Authorized Official - Credentials:PT MS
Authorized Official - Phone:917-971-7888
Mailing Address - Street 1:157 W 91ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1301
Mailing Address - Country:US
Mailing Address - Phone:917-971-7888
Mailing Address - Fax:347-699-1053
Practice Address - Street 1:157 W 91ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1301
Practice Address - Country:US
Practice Address - Phone:917-971-7888
Practice Address - Fax:347-699-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty