Provider Demographics
NPI:1497910616
Name:BREWSTER PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:BREWSTER PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CAPONE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:845-278-4127
Mailing Address - Street 1:211 CLOCK TOWER COMMONS
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4057
Mailing Address - Country:US
Mailing Address - Phone:845-278-4127
Mailing Address - Fax:845-278-4128
Practice Address - Street 1:211 CLOCK TOWER COMMONS
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4057
Practice Address - Country:US
Practice Address - Phone:845-278-4127
Practice Address - Fax:845-278-4128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008679261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1215113139OtherSUSAN DALLMANN LAMBROS, P.T., M.S.
NY1144421553OtherDOMINIC JAMES CAPONE, M.S., P.T.