Provider Demographics
NPI:1760770606
Name:SPORTS PHYSICAL THERAPY OF NEW YORK, PC
Entity Type:Organization
Organization Name:SPORTS PHYSICAL THERAPY OF NEW YORK, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO PT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:315-410-6200
Mailing Address - Street 1:807 RIDGE RD STE B
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2497
Mailing Address - Country:US
Mailing Address - Phone:585-347-0202
Mailing Address - Fax:585-347-0203
Practice Address - Street 1:807 RIDGE RD STE B
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2497
Practice Address - Country:US
Practice Address - Phone:585-347-0202
Practice Address - Fax:585-347-0203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPORTS PHYSICAL THERAPY OF NEW YORK, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty