Provider Demographics
NPI:1902814213
Name:DEMASE, PHILIP (PT)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:DEMASE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3081 CHEN CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-1972
Mailing Address - Country:US
Mailing Address - Phone:914-299-4976
Mailing Address - Fax:914-276-0195
Practice Address - Street 1:293 ROUTE 100
Practice Address - Street 2:SUITE 107
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-3213
Practice Address - Country:US
Practice Address - Phone:914-279-2520
Practice Address - Fax:914-276-0195
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008933-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ6811QD252Medicare PIN