Provider Demographics
NPI:1851143465
Name:MONARCH PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:MONARCH PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZARDI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:845-663-7427
Mailing Address - Street 1:126 MAIN ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1525
Mailing Address - Country:US
Mailing Address - Phone:845-663-7427
Mailing Address - Fax:
Practice Address - Street 1:126 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1525
Practice Address - Country:US
Practice Address - Phone:845-663-7427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty