Provider Demographics
NPI:1255018198
Name:SHARON FONG PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:SHARON FONG PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-216-3779
Mailing Address - Street 1:39 MIDDLE PATENT RD
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-2805
Mailing Address - Country:US
Mailing Address - Phone:845-216-3779
Mailing Address - Fax:212-223-0198
Practice Address - Street 1:39 MIDDLE PATENT RD
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-2805
Practice Address - Country:US
Practice Address - Phone:845-216-3779
Practice Address - Fax:212-223-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty