Provider Demographics
NPI:1851475354
Name:OPTIMUM PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:OPTIMUM PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:DIBBINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-395-3290
Mailing Address - Street 1:73 SULGRAVE ROAD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-395-3290
Mailing Address - Fax:
Practice Address - Street 1:2025 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2427
Practice Address - Country:US
Practice Address - Phone:914-395-3290
Practice Address - Fax:914-395-0247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02361315Medicaid
Q0W4A1Medicare UPIN
NY02361315Medicaid
P81086Medicare UPIN
NYQ0W4A1Medicare PIN