Provider Demographics
NPI:1467408252
Name:PLISKOW, ADAM (PT)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:PLISKOW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SCHUMAN RD
Mailing Address - Street 2:NEW CASTLE PHYSICAL THERAPY
Mailing Address - City:MILLWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10546-1111
Mailing Address - Country:US
Mailing Address - Phone:914-488-5440
Mailing Address - Fax:914-488-5441
Practice Address - Street 1:16 SCHUMAN RD
Practice Address - Street 2:NEW CASTLE PHYSICAL THERAPY
Practice Address - City:MILLWOOD
Practice Address - State:NY
Practice Address - Zip Code:10546-1111
Practice Address - Country:US
Practice Address - Phone:914-488-5440
Practice Address - Fax:914-488-5441
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ10V61Medicare ID - Type UnspecifiedEMPIRE MEDICARE