Provider Demographics
NPI:1477637569
Name:PHYSICAL THERAPY ASSOCIATES OF SCHENECTADY, P.C.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY ASSOCIATES OF SCHENECTADY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:COONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:518-374-2242
Mailing Address - Street 1:2345 NOTT ST E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-4302
Mailing Address - Country:US
Mailing Address - Phone:518-374-2242
Mailing Address - Fax:518-374-2025
Practice Address - Street 1:2345 NOTT ST E
Practice Address - Street 2:SUITE 100
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-4302
Practice Address - Country:US
Practice Address - Phone:518-374-2242
Practice Address - Fax:518-374-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
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
NY56563AMedicare ID - Type Unspecified