Provider Demographics
NPI:1477701712
Name:ELIZABETH INGALLS PHYSICAL THERAPIST PLLC
Entity Type:Organization
Organization Name:ELIZABETH INGALLS PHYSICAL THERAPIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:INGALLS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,PT,CST
Authorized Official - Phone:914-261-1060
Mailing Address - Street 1:1 PENFIELD AVENUE
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-3014
Mailing Address - Country:US
Mailing Address - Phone:914-261-1060
Mailing Address - Fax:914-271-2713
Practice Address - Street 1:1 PENFIELD AVE
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-3014
Practice Address - Country:US
Practice Address - Phone:914-261-1060
Practice Address - Fax:914-271-2713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015539-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty