Provider Demographics
NPI:1245447663
Name:METRO SPORTS PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:METRO SPORTS PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SEJAL
Authorized Official - Middle Name:
Authorized Official - Last Name:VYAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:646-742-0165
Mailing Address - Street 1:303 PARK AVE S
Mailing Address - Street 2:#1243
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-3601
Mailing Address - Country:US
Mailing Address - Phone:646-742-0165
Mailing Address - Fax:646-742-0462
Practice Address - Street 1:113 E 23RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4507
Practice Address - Country:US
Practice Address - Phone:646-742-0165
Practice Address - Fax:646-742-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy