Provider Demographics
NPI:1437399425
Name:LOTUS PHYSICAL THERAPY FOR WOMEN, PLLC
Entity Type:Organization
Organization Name:LOTUS PHYSICAL THERAPY FOR WOMEN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUBA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STAROSTIAK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-282-5532
Mailing Address - Street 1:667 S MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5709
Mailing Address - Country:US
Mailing Address - Phone:914-282-5532
Mailing Address - Fax:845-634-2402
Practice Address - Street 1:105 SHAD ROW
Practice Address - Street 2:
Practice Address - City:PIERMONT
Practice Address - State:NY
Practice Address - Zip Code:10968-3001
Practice Address - Country:US
Practice Address - Phone:914-282-5532
Practice Address - Fax:845-634-2402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01254812251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty