Provider Demographics
NPI:1437120987
Name:NEW YORK PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:NEW YORK PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:516-825-1112
Mailing Address - Street 1:68 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5407
Mailing Address - Country:US
Mailing Address - Phone:516-825-1112
Mailing Address - Fax:
Practice Address - Street 1:68 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5407
Practice Address - Country:US
Practice Address - Phone:516-825-1112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA475926OtherOXFORD PROVIDER NUMBER
NY6602469OtherGHI PROVIDER NUMBER
NYQ51621OtherBLUE CROSS PROVIDER #
NY2C5440OtherHEALTHNET PROVIDER NUMBER