Provider Demographics
NPI:1811005424
Name:INNOVATIVE APPROACH PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:INNOVATIVE APPROACH PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GATTONI
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:212-757-2202
Mailing Address - Street 1:729 SEVENTH AVE
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6831
Mailing Address - Country:US
Mailing Address - Phone:212-757-2202
Mailing Address - Fax:212-757-2206
Practice Address - Street 1:729 SEVENTH AVE
Practice Address - Street 2:14TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6831
Practice Address - Country:US
Practice Address - Phone:212-757-2202
Practice Address - Fax:212-757-2206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019698 12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9729126OtherCIGNA PPO
NYQ11T71OtherBCBS
NYQ4WOD1Medicare ID - Type Unspecified
NY9729126OtherCIGNA PPO