Provider Demographics
NPI:1326333030
Name:PHYSICAL THERAPIST, PC
Entity Type:Organization
Organization Name:PHYSICAL THERAPIST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:DEVLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-225-2381
Mailing Address - Street 1:1 PHEASANT PL
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-1612
Mailing Address - Country:US
Mailing Address - Phone:845-225-2381
Mailing Address - Fax:845-225-7605
Practice Address - Street 1:1 PHEASANT PL
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-1612
Practice Address - Country:US
Practice Address - Phone:845-225-2381
Practice Address - Fax:845-225-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006353-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health