Provider Demographics
NPI:1205130622
Name:BODHIMOTION PHYSICAL THERAPY AND WELLNESS PLLC
Entity type:Organization
Organization Name:BODHIMOTION PHYSICAL THERAPY AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:212-529-5700
Mailing Address - Street 1:110 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4517
Mailing Address - Country:US
Mailing Address - Phone:212-529-5700
Mailing Address - Fax:212-529-3415
Practice Address - Street 1:155 E 31ST ST
Practice Address - Street 2:APT 15A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6800
Practice Address - Country:US
Practice Address - Phone:212-529-5700
Practice Address - Fax:212-529-3415
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BODHIMOTION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-28
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023936225100000X
NY023860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty