Provider Demographics
NPI:1437235108
Name:PHYSICAL THERAPY OPTIONS PC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY OPTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COORS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-747-1520
Mailing Address - Street 1:226 SEVENTH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-747-1520
Mailing Address - Fax:516-747-1552
Practice Address - Street 1:226 SEVENTH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-747-1520
Practice Address - Fax:516-747-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0229111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02692684Medicaid
Q6W3J1Medicare ID - Type Unspecified