Provider Demographics
NPI:1356464218
Name:ALIGN PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ALIGN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-566-3514
Mailing Address - Street 1:1400 ROUTE 300
Mailing Address - Street 2:SUITE 9
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2995
Mailing Address - Country:US
Mailing Address - Phone:845-566-3514
Mailing Address - Fax:845-566-3518
Practice Address - Street 1:1400 ROUTE 300
Practice Address - Street 2:SUITE 9
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2995
Practice Address - Country:US
Practice Address - Phone:845-566-3514
Practice Address - Fax:845-566-3518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014752-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ1WFE1Medicare ID - Type UnspecifiedPHYSICAL THERAPY
NYQ04251Medicare ID - Type UnspecifiedPHYSICAL THERAPY