Provider Demographics
NPI:1417160490
Name:SYRACUSE PHYSICAL THERAPY PARTNERS
Entity Type:Organization
Organization Name:SYRACUSE PHYSICAL THERAPY PARTNERS
Other - Org Name:AQUACARE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-548-7600
Mailing Address - Street 1:38069 TOWN CENTER DR UNIT 15
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19967-6968
Mailing Address - Country:US
Mailing Address - Phone:302-539-3110
Mailing Address - Fax:302-539-7237
Practice Address - Street 1:38069 TOWN CENTER DR UNIT 15
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:DE
Practice Address - Zip Code:19967-6968
Practice Address - Country:US
Practice Address - Phone:302-539-3110
Practice Address - Fax:302-539-7237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty