Provider Demographics
NPI:1558788943
Name:COLD SPRING PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:COLD SPRING PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ASTRAB
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, MS
Authorized Official - Phone:845-424-6422
Mailing Address - Street 1:1760 SOUTH, ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10524
Mailing Address - Country:US
Mailing Address - Phone:845-424-6422
Mailing Address - Fax:
Practice Address - Street 1:1760 SOUTH, ROUTE 9
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524
Practice Address - Country:US
Practice Address - Phone:845-424-6422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2014-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023964-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942205158Medicare NSC