Provider Demographics
NPI:1477930055
Name:ORTHOPEDIC MOVEMENT PT, PLLC
Entity Type:Organization
Organization Name:ORTHOPEDIC MOVEMENT PT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:MIHO
Authorized Official - Middle Name:
Authorized Official - Last Name:URISAKA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:212-695-2769
Mailing Address - Street 1:50 E 42ND ST RM 1200
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5441
Mailing Address - Country:US
Mailing Address - Phone:212-695-2769
Mailing Address - Fax:646-213-7725
Practice Address - Street 1:50 E 42ND ST RM 1200
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5441
Practice Address - Country:US
Practice Address - Phone:212-695-2769
Practice Address - Fax:646-213-7725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-02
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031717261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy