Provider Demographics
NPI:1972215713
Name:COLLINS PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:COLLINS PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-241-3698
Mailing Address - Street 1:158 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-5202
Mailing Address - Country:US
Mailing Address - Phone:631-241-3698
Mailing Address - Fax:
Practice Address - Street 1:36 W 44TH ST STE 302B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8105
Practice Address - Country:US
Practice Address - Phone:631-241-3698
Practice Address - Fax:212-391-8360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-22
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy