Provider Demographics
NPI:1689045858
Name:NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED
Entity Type:Organization
Organization Name:NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED
Other - Org Name:PT AFFILIATED WITH HSS - IMG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE V.P. & CFO
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALAKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-606-1239
Mailing Address - Street 1:535 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4823
Mailing Address - Country:US
Mailing Address - Phone:212-606-1239
Mailing Address - Fax:
Practice Address - Street 1:5500 34TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3506
Practice Address - Country:US
Practice Address - Phone:941-749-8760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty