Provider Demographics
NPI:1467731869
Name:NY PHYSICAL THERAPY & WELLNESS, ELMHURST, PLLC
Entity Type:Organization
Organization Name:NY PHYSICAL THERAPY & WELLNESS, ELMHURST, PLLC
Other - Org Name:NY PHYSICAL THERAPY & WELLNESS
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:FEBRARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-261-9510
Mailing Address - Street 1:7425 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4126
Mailing Address - Country:US
Mailing Address - Phone:718-478-8400
Mailing Address - Fax:718-478-8401
Practice Address - Street 1:7425 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4126
Practice Address - Country:US
Practice Address - Phone:718-478-8400
Practice Address - Fax:718-478-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2018-01-26
Deactivation Date:2017-12-11
Deactivation Code:
Reactivation Date:2018-01-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty