Provider Demographics
NPI:1497874861
Name:PARK SOUTH PHYSICAL THERAPY GROUP PC
Entity Type:Organization
Organization Name:PARK SOUTH PHYSICAL THERAPY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-647-8130
Mailing Address - Street 1:37 UNION SQ W
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3217
Mailing Address - Country:US
Mailing Address - Phone:212-647-8130
Mailing Address - Fax:212-647-8648
Practice Address - Street 1:37 UNION SQ W
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3217
Practice Address - Country:US
Practice Address - Phone:212-647-8130
Practice Address - Fax:212-647-8648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6647261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWQW331Medicare PIN
NYQ6759QW331Medicare PIN
NYQ6708QW331Medicare PIN