Provider Demographics
NPI:1356565899
Name:EMPIRE PHYSICAL THERAPY & ALTHLETIC REHABILITATION P.C.
Entity type:Organization
Organization Name:EMPIRE PHYSICAL THERAPY & ALTHLETIC REHABILITATION P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LA ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:212-355-4481
Mailing Address - Street 1:133 E 58TH ST
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1236
Mailing Address - Country:US
Mailing Address - Phone:212-355-4481
Mailing Address - Fax:212-355-4489
Practice Address - Street 1:133 E 58TH ST
Practice Address - Street 2:SUITE 1001
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1236
Practice Address - Country:US
Practice Address - Phone:212-355-4481
Practice Address - Fax:212-355-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016429-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ0W8C1Medicare PIN