Provider Demographics
NPI:1255951075
Name:CONNECT PHYSICAL THERAPY NYC
Entity type:Organization
Organization Name:CONNECT PHYSICAL THERAPY NYC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERALTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-954-5902
Mailing Address - Street 1:2761 DECATUR AVE APT 5A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-3753
Mailing Address - Country:US
Mailing Address - Phone:718-954-5902
Mailing Address - Fax:847-886-7525
Practice Address - Street 1:2761 DECATUR AVE APT 5A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-3753
Practice Address - Country:US
Practice Address - Phone:718-954-5902
Practice Address - Fax:847-886-7525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty