Provider Demographics
NPI:1023229200
Name:ADIRONDACK PHYSICAL THERAPY AND FITNESS, PLLC
Entity type:Organization
Organization Name:ADIRONDACK PHYSICAL THERAPY AND FITNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-623-2888
Mailing Address - Street 1:PO BOX 762
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12885-0762
Mailing Address - Country:US
Mailing Address - Phone:518-623-2888
Mailing Address - Fax:518-430-0088
Practice Address - Street 1:3971 MAIN ST
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:NY
Practice Address - Zip Code:12885-1152
Practice Address - Country:US
Practice Address - Phone:518-623-2888
Practice Address - Fax:518-430-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-27
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA1176Medicare PIN