Provider Demographics
NPI:1891140323
Name:LOWER MANHATTAN PHYSICAL THERAPY
Entity Type:Organization
Organization Name:LOWER MANHATTAN PHYSICAL THERAPY
Other - Org Name:RANGE OF MOTION PHYSICAL THERAPY, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:412-654-3212
Mailing Address - Street 1:4 CORNWALL DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3332
Mailing Address - Country:US
Mailing Address - Phone:732-257-0900
Mailing Address - Fax:732-257-5099
Practice Address - Street 1:4 CORNWALL DR
Practice Address - Street 2:SUITE 220
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3332
Practice Address - Country:US
Practice Address - Phone:732-257-0900
Practice Address - Fax:732-257-5099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWER MANHATTAN PHYSICAL THERAPY & SPORTS REHAB., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62024977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty