Provider Demographics
NPI:1467628172
Name:WESTCHESTER GAO PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:WESTCHESTER GAO PHYSICAL THERAPY PC
Other - Org Name:NEWYORK GAO PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:X
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC DIPL AC PT
Authorized Official - Phone:914-421-1600
Mailing Address - Street 1:116 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1910
Mailing Address - Country:US
Mailing Address - Phone:914-421-1600
Mailing Address - Fax:
Practice Address - Street 1:116 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1910
Practice Address - Country:US
Practice Address - Phone:914-421-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013918-1261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ23041OtherMEDICARE PROVIDER ID#