Provider Demographics
NPI:1942205158
Name:ASTRAB, JOHN (MS PT OCS CSCS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:ASTRAB
Suffix:
Gender:M
Credentials:MS PT OCS CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 SOUTH ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10524-3852
Mailing Address - Country:US
Mailing Address - Phone:845-424-6422
Mailing Address - Fax:
Practice Address - Street 1:1760 SOUTH ROUTE 9
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524-3852
Practice Address - Country:US
Practice Address - Phone:845-424-6422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0013701OtherORTHONET AETNA HMO
0222701OtherORTHONET CIGNA HMO
0222701OtherORTHONET USFH
133542448OtherPHCS
5466920OtherCIGNA PPO
133542448-17OtherFIRST HEALTH/ICM
3104338OtherAETNA HMO
133542448OtherPOMCO
7473440OtherAETNA PPO
NYQP3601OtherEMPIRE BC/BS
109230200OtherUS DEPT OF LABOR
0222701OtherORTHONET HEALTHNET
133542448-02OtherLOCAL 1199
7473440OtherAETNA PPO
NYQP2211Medicare ID - Type Unspecified