Provider Demographics
NPI: | 1508986464 |
---|---|
Name: | ELITE PHYSICAL THERAPY AND REHABILITATION LLC |
Entity Type: | Organization |
Organization Name: | ELITE PHYSICAL THERAPY AND REHABILITATION LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CLEOPATRA |
Authorized Official - Middle Name: | Y |
Authorized Official - Last Name: | ESPINOSA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS, DPT |
Authorized Official - Phone: | 914-328-3888 |
Mailing Address - Street 1: | 3010 WESTCHESTER AVE |
Mailing Address - Street 2: | SUITE 107 |
Mailing Address - City: | PURCHASE |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10577 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 914-328-3888 |
Mailing Address - Fax: | 914-328-2228 |
Practice Address - Street 1: | 3010 WESTCHESTER AVE |
Practice Address - Street 2: | SUITE 107 |
Practice Address - City: | PURCHASE |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10577 |
Practice Address - Country: | US |
Practice Address - Phone: | 914-328-3888 |
Practice Address - Fax: | 914-328-2228 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-04-01 |
Last Update Date: | 2020-10-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 019466-1 | 225100000X, 2251E1200X, 2251E1300X, 2251G0304X, 2251H1200X, 2251H1300X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X |
225100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 2251E1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics | Group - Multi-Specialty |
No | 2251E1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Electrophysiology, Clinical | Group - Multi-Specialty |
No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics | Group - Multi-Specialty |
No | 2251H1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Hand | Group - Multi-Specialty |
No | 2251H1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Human Factors | Group - Multi-Specialty |
No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | Group - Multi-Specialty |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | Group - Multi-Specialty |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 50501 | Other | CIGNA HEALTHCARE |
NY | Q01S71 | Other | EMPIRE BCBS |
NY | P3103300 | Other | OXFORD HEALTH PLAN |
NY | 1000039298 | Other | AFFINITY HEALTH PLAN |
NY | 1950657 | Other | UNITED HEALTHCARE |
NY | 019466-A14 | Other | HEALTH FIRST |
NY | OH3254 | Other | HEALTHNET |
NY | 806035 | Other | MPN |
NY | 03206008 | Medicaid | |
NY | 19466 | Other | HIP |
NY | 2119568 | Other | FIRST HEALTH |
NY | 30265 | Other | CMO (HMO) MONTEFIORE |
NY | 7326527 | Other | AETNA |