Provider Demographics
NPI:1205073418
Name:PROFESSIONAL SPORTSCARE OF NEW YORK, LLC
Entity type:Organization
Organization Name:PROFESSIONAL SPORTSCARE OF NEW YORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:443-506-8272
Mailing Address - Street 1:102 FAIRVIEW PK DR
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-1518
Mailing Address - Country:US
Mailing Address - Phone:914-345-6080
Mailing Address - Fax:914-345-6083
Practice Address - Street 1:102 FAIRVIEW PK DR
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-1518
Practice Address - Country:US
Practice Address - Phone:914-345-6080
Practice Address - Fax:914-345-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty