Provider Demographics
NPI:1730316365
Name:WESTMINSTER PHYSICAL THERAPY OF NEW YORK PLLC
Entity Type:Organization
Organization Name:WESTMINSTER PHYSICAL THERAPY OF NEW YORK PLLC
Other - Org Name:WESTMINSTER PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUPAZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-544-6677
Mailing Address - Street 1:6433 98TH ST
Mailing Address - Street 2:STE. LL1
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3321
Mailing Address - Country:US
Mailing Address - Phone:718-544-6677
Mailing Address - Fax:718-544-6688
Practice Address - Street 1:6433 98TH ST
Practice Address - Street 2:STE. LL1
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3321
Practice Address - Country:US
Practice Address - Phone:718-544-6677
Practice Address - Fax:718-544-6688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty