Provider Demographics
NPI:1700859014
Name:GREENHAUS PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:GREENHAUS PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:F
Authorized Official - Last Name:GREENHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-367-1111
Mailing Address - Street 1:150 WOODBURY ROAD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797
Mailing Address - Country:US
Mailing Address - Phone:516-367-1111
Mailing Address - Fax:516-367-3701
Practice Address - Street 1:150 WOODBURY ROAD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797
Practice Address - Country:US
Practice Address - Phone:516-367-1111
Practice Address - Fax:516-367-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ62581Medicare ID - Type Unspecified