Provider Demographics
NPI:1770847121
Name:DOROTHY PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:DOROTHY PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:GAY
Authorized Official - Last Name:PANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-769-0675
Mailing Address - Street 1:14226 37TH AVE # C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4103
Mailing Address - Country:US
Mailing Address - Phone:718-359-6600
Mailing Address - Fax:
Practice Address - Street 1:14226 37TH AVE # C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4103
Practice Address - Country:US
Practice Address - Phone:718-359-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-30
Last Update Date:2012-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029224261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty