Provider Demographics
NPI:1467112946
Name:IRWIN PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:IRWIN PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-745-4017
Mailing Address - Street 1:2802 MORELAND ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2422
Mailing Address - Country:US
Mailing Address - Phone:917-476-5286
Mailing Address - Fax:
Practice Address - Street 1:654 ROUTE 6 STE 1
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-6612
Practice Address - Country:US
Practice Address - Phone:845-745-4017
Practice Address - Fax:845-259-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy