Provider Demographics
NPI:1508376625
Name:THERYON, INC
Entity Type:Organization
Organization Name:THERYON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YITZCHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLODNY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-220-0649
Mailing Address - Street 1:333 PEARSALL AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1842
Mailing Address - Country:US
Mailing Address - Phone:516-220-0649
Mailing Address - Fax:516-569-1850
Practice Address - Street 1:333 PEARSALL AVE STE 203
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1842
Practice Address - Country:US
Practice Address - Phone:516-220-0649
Practice Address - Fax:516-569-1850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty