Provider Demographics
NPI:1437896586
Name:IMPACT PT & ERGONOMIC SOLUTIONS PLLC
Entity Type:Organization
Organization Name:IMPACT PT & ERGONOMIC SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:CAREY
Authorized Official - Last Name:FRIEDLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CHT
Authorized Official - Phone:631-219-4402
Mailing Address - Street 1:123 MASON ST UNIT 8
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6605
Mailing Address - Country:US
Mailing Address - Phone:203-900-1220
Mailing Address - Fax:
Practice Address - Street 1:36 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-4313
Practice Address - Country:US
Practice Address - Phone:631-219-4402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty