Provider Demographics
NPI:1952633182
Name:NGH PHYSICAL THERAPY ASSOCIATES, PC
Entity Type:Organization
Organization Name:NGH PHYSICAL THERAPY ASSOCIATES, PC
Other - Org Name:LATTIMORE OF IRONDEQUOIT PHYSICAL THEARPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:585-227-2310
Mailing Address - Street 1:1299 PORTLAND AVE
Mailing Address - Street 2:STE 10
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2730
Mailing Address - Country:US
Mailing Address - Phone:585-227-2310
Mailing Address - Fax:585-227-2312
Practice Address - Street 1:1299 PORTLAND AVE
Practice Address - Street 2:STE 10
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2730
Practice Address - Country:US
Practice Address - Phone:585-227-2310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty