Provider Demographics
NPI:1790110518
Name:MOVING FORWARD PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:MOVING FORWARD PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:VITALY
Authorized Official - Middle Name:
Authorized Official - Last Name:DVOSKIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:917-604-8612
Mailing Address - Street 1:116 E 60TH ST
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1107
Mailing Address - Country:US
Mailing Address - Phone:917-604-8612
Mailing Address - Fax:
Practice Address - Street 1:605 MADISON AVE
Practice Address - Street 2:4TH FLOOR/JFGYMNASTIQUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1900
Practice Address - Country:US
Practice Address - Phone:917-604-8612
Practice Address - Fax:888-705-2297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-11
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0308732251X0800X
NJ40QA013283002251X0800X
CA362602251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty