Provider Demographics
NPI:1518245224
Name:ASCENT WELLNESS PT OT LMT PLLC
Entity Type:Organization
Organization Name:ASCENT WELLNESS PT OT LMT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRZASKOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-534-3903
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:WILLSBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12996-0023
Mailing Address - Country:US
Mailing Address - Phone:518-534-3903
Mailing Address - Fax:
Practice Address - Street 1:2885 ESSEX RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:NY
Practice Address - Zip Code:12936-2317
Practice Address - Country:US
Practice Address - Phone:518-963-7509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013882225100000X
NY018365225700000X
NY018647225700000X
NY010698225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty