Provider Demographics
NPI:1477508885
Name:EAST & WEST PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:EAST & WEST PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/SOLE OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:INGA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEITLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-563-1200
Mailing Address - Street 1:1957 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2328
Mailing Address - Country:US
Mailing Address - Phone:347-563-1200
Mailing Address - Fax:718-236-1195
Practice Address - Street 1:1957 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2328
Practice Address - Country:US
Practice Address - Phone:347-563-1200
Practice Address - Fax:718-236-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty