Provider Demographics
NPI:1417181744
Name:ST.THOMAS PHYSICAL THERAPY,PC.
Entity Type:Organization
Organization Name:ST.THOMAS PHYSICAL THERAPY,PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHAY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-514-5152
Mailing Address - Street 1:881 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1840
Mailing Address - Country:US
Mailing Address - Phone:201-836-8796
Mailing Address - Fax:201-836-8796
Practice Address - Street 1:591 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4727
Practice Address - Country:US
Practice Address - Phone:718-901-7555
Practice Address - Fax:718-901-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022012174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty