Provider Demographics
NPI:1861636557
Name:RECOVERY PHYSICAL THERAPY
Entity Type:Organization
Organization Name:RECOVERY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:DESMOND
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-953-9494
Mailing Address - Street 1:1385 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3933
Mailing Address - Country:US
Mailing Address - Phone:914-315-1800
Mailing Address - Fax:914-315-1799
Practice Address - Street 1:530 7TH AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-4878
Practice Address - Country:US
Practice Address - Phone:212-840-3030
Practice Address - Fax:212-840-3063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
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
NYQHW442Medicare Oscar/Certification