Provider Demographics
NPI:1336756758
Name:BESPOKE TREATMENTS PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:BESPOKE TREATMENTS PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING/COLLECTIONS
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-596-7427
Mailing Address - Street 1:295 MADISON AVE
Mailing Address - Street 2:SUITE 1801
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6404
Mailing Address - Country:US
Mailing Address - Phone:646-596-7427
Mailing Address - Fax:646-358-3443
Practice Address - Street 1:295 MADISON AVE
Practice Address - Street 2:SUITE 1801
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6404
Practice Address - Country:US
Practice Address - Phone:646-596-7427
Practice Address - Fax:646-358-3443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy