Provider Demographics
NPI:1518310002
Name:PACT PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:PACT PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-290-6488
Mailing Address - Street 1:133 E 55TH ST
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3502
Mailing Address - Country:US
Mailing Address - Phone:646-290-6488
Mailing Address - Fax:646-690-1313
Practice Address - Street 1:133 E 55TH ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3502
Practice Address - Country:US
Practice Address - Phone:646-290-6488
Practice Address - Fax:646-690-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038507-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy