Provider Demographics
NPI:1942334677
Name:POMONA PHYSICAL THERAPY ASSOCIATES P.C.
Entity Type:Organization
Organization Name:POMONA PHYSICAL THERAPY ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:MITTAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-362-3089
Mailing Address - Street 1:978 ROUTE 45
Mailing Address - Street 2:NORTH SIDE PLAZA, SUITE100
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970
Mailing Address - Country:US
Mailing Address - Phone:845-362-3089
Mailing Address - Fax:845-362-3006
Practice Address - Street 1:978 ROUTE 45
Practice Address - Street 2:NORTH SIDE PLAZA, SUITE100
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3521
Practice Address - Country:US
Practice Address - Phone:845-362-3089
Practice Address - Fax:845-362-3006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008185-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty