Provider Demographics
NPI:1417004896
Name:APALACHIN PHYSICAL THERAPY,PLLC
Entity Type:Organization
Organization Name:APALACHIN PHYSICAL THERAPY,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRUPTI
Authorized Official - Middle Name:M
Authorized Official - Last Name:KANERIA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:607-625-2022
Mailing Address - Street 1:6843 STATE ROUTE 434
Mailing Address - Street 2:SUITE 1
Mailing Address - City:APALACHIN
Mailing Address - State:NY
Mailing Address - Zip Code:13732-3503
Mailing Address - Country:US
Mailing Address - Phone:607-625-2022
Mailing Address - Fax:607-258-0293
Practice Address - Street 1:6843 STATE ROUTE 434
Practice Address - Street 2:SUITE 1
Practice Address - City:APALACHIN
Practice Address - State:NY
Practice Address - Zip Code:13732-3503
Practice Address - Country:US
Practice Address - Phone:607-625-2022
Practice Address - Fax:607-258-0293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0124Medicare PIN