Provider Demographics
NPI:1962448910
Name:PHYSICAL THERAPY & SPORTS CHIROPRACTIC OF YORKTOWN, PLLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY & SPORTS CHIROPRACTIC OF YORKTOWN, PLLC
Other - Org Name:SPORTS THERAPY OF YORKTOWN, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:A
Authorized Official - Last Name:ESSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:914-962-0100
Mailing Address - Street 1:2050 SAW MILL RIVER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4108
Mailing Address - Country:US
Mailing Address - Phone:914-962-0100
Mailing Address - Fax:914-962-0105
Practice Address - Street 1:2050 SAW MILL RIVER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4108
Practice Address - Country:US
Practice Address - Phone:914-962-0100
Practice Address - Fax:914-962-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004874-1111N00000X
NY014898-2225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXAWKP1Medicare ID - Type UnspecifiedGROUP NUMBER