Provider Demographics
NPI:1952465338
Name:PELHAM PHYSICAL MEDICINE INC
Entity Type:Organization
Organization Name:PELHAM PHYSICAL MEDICINE INC
Other - Org Name:ASSISTANCE BY IMPROV LL INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLMUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-823-3900
Mailing Address - Street 1:2118 WILLIAMSBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1602
Mailing Address - Country:US
Mailing Address - Phone:718-823-3900
Mailing Address - Fax:718-823-3961
Practice Address - Street 1:2118 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1602
Practice Address - Country:US
Practice Address - Phone:718-823-3900
Practice Address - Fax:718-823-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167018-1207R00000X, 207R00000X
NY041-0-100251K00000X, 251K00000X
NY189920-1261QP2000X, 261QP2000X
NY165628103TP0016X, 103TM1800X
NY0768991041C0700X
NY076899-1106H00000X
NYF335470176B00000X
NYR029782251B00000X
343900000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1962639079Medicaid
NY171001539Medicaid
NY01841013Medicaid
NY1144262510Medicare ID - Type Unspecified