Provider Demographics
NPI:1679855688
Name:CYNERGY EAST PHYSICAL THEARAPY, P.C.
Entity Type:Organization
Organization Name:CYNERGY EAST PHYSICAL THEARAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-974-7252
Mailing Address - Street 1:160 E 93RD ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3711
Mailing Address - Country:US
Mailing Address - Phone:212-974-7252
Mailing Address - Fax:212-974-7228
Practice Address - Street 1:160 E 93RD ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3711
Practice Address - Country:US
Practice Address - Phone:212-974-7252
Practice Address - Fax:212-974-7228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032302174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400042074Medicare PIN