Provider Demographics
NPI:1477589984
Name:NEIL J. ANASTASIO
Entity Type:Organization
Organization Name:NEIL J. ANASTASIO
Other - Org Name:RIDGE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANASTASIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-745-8282
Mailing Address - Street 1:7410 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1942
Mailing Address - Country:US
Mailing Address - Phone:718-745-8282
Mailing Address - Fax:718-745-4394
Practice Address - Street 1:7410 11TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-1942
Practice Address - Country:US
Practice Address - Phone:718-745-8282
Practice Address - Fax:718-745-4394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQOW021Medicare ID - Type UnspecifiedPHYSICAL THERAPY