Provider Demographics
NPI:1619942299
Name:FUNCTION FIRST PHYSICAL THERAPY P C
Entity Type:Organization
Organization Name:FUNCTION FIRST PHYSICAL THERAPY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPALLONE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, PT
Authorized Official - Phone:212-691-4833
Mailing Address - Street 1:119 W 23RD ST
Mailing Address - Street 2:SUITE 804
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2427
Mailing Address - Country:US
Mailing Address - Phone:212-691-4833
Mailing Address - Fax:212-691-4532
Practice Address - Street 1:119 W 23RD ST
Practice Address - Street 2:SUITE 804
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2427
Practice Address - Country:US
Practice Address - Phone:212-691-4833
Practice Address - Fax:212-691-4532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ6WBB1Medicare PIN