Provider Demographics
NPI:1750815593
Name:SNYS PHYSICAL THERAPY LLC.
Entity Type:Organization
Organization Name:SNYS PHYSICAL THERAPY LLC.
Other - Org Name:SNYSPTLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:845-527-8008
Mailing Address - Street 1:172 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1634
Mailing Address - Country:US
Mailing Address - Phone:845-527-8008
Mailing Address - Fax:201-820-4365
Practice Address - Street 1:629 WEST 185TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1634
Practice Address - Country:US
Practice Address - Phone:845-527-8008
Practice Address - Fax:201-820-4365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 252Y00000X
010909261QA0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251E00000XAgenciesHome Health
No261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility