Provider Demographics
NPI:1417045899
Name:ONE STEP AHEAD PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:ONE STEP AHEAD PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:DANDROW
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT
Authorized Official - Phone:518-561-2225
Mailing Address - Street 1:2 HEALEY AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2413
Mailing Address - Country:US
Mailing Address - Phone:518-561-2225
Mailing Address - Fax:518-561-2212
Practice Address - Street 1:2 HEALEY AVE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2413
Practice Address - Country:US
Practice Address - Phone:518-561-2225
Practice Address - Fax:518-561-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013185-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA1062Medicare PIN