Provider Demographics
NPI:1497852792
Name:BECK, ROBERT T JR (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:BECK
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 ROUTE 94
Mailing Address - Street 2:STATION ROAD SQUARE
Mailing Address - City:SALISBURY MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12577
Mailing Address - Country:US
Mailing Address - Phone:845-497-1099
Mailing Address - Fax:845-497-1094
Practice Address - Street 1:2130 ROUTE 94
Practice Address - Street 2:STATION ROAD SQUARE
Practice Address - City:SALISBURY MILLS
Practice Address - State:NY
Practice Address - Zip Code:12577
Practice Address - Country:US
Practice Address - Phone:845-497-1099
Practice Address - Fax:845-497-1094
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016310-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQK773Q0SK1Medicare PIN