Provider Demographics
NPI:1205519543
Name:GEEVARUGHESE, BOBBY (DPT)
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:
Last Name:GEEVARUGHESE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CONSULATE DR APT 1D
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-2402
Mailing Address - Country:US
Mailing Address - Phone:845-536-7297
Mailing Address - Fax:
Practice Address - Street 1:1440 CENTRAL AVE STE 14 #1002
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205
Practice Address - Country:US
Practice Address - Phone:914-586-3931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist