Provider Demographics
NPI:1255770137
Name:GET UP AND GO PHYSICAL THERAPY AND WELLNESS, PLLC
Entity type:Organization
Organization Name:GET UP AND GO PHYSICAL THERAPY AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAQUI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-233-0889
Mailing Address - Street 1:107 E BROADWAY FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7037
Mailing Address - Country:US
Mailing Address - Phone:212-233-0889
Mailing Address - Fax:212-233-0898
Practice Address - Street 1:107 E BROADWAY FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7037
Practice Address - Country:US
Practice Address - Phone:212-233-0889
Practice Address - Fax:212-233-0898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03237670Medicaid
NY03237670Medicaid