Provider Demographics
NPI:1568449759
Name:NEW YORK PHYSICAL THERAPY SERVICE,PC
Entity Type:Organization
Organization Name:NEW YORK PHYSICAL THERAPY SERVICE,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSIER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-619-5062
Mailing Address - Street 1:100 JOHN ST
Mailing Address - Street 2:SUITE 2208
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-3807
Mailing Address - Country:US
Mailing Address - Phone:212-619-5062
Mailing Address - Fax:
Practice Address - Street 1:100 JOHN ST
Practice Address - Street 2:SUITE 2208
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-3807
Practice Address - Country:US
Practice Address - Phone:212-619-5062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ54191Medicare ID - Type Unspecified
NYQ54111Medicare ID - Type Unspecified