Provider Demographics
NPI:1457746505
Name:MOTIV NY PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:MOTIV NY PHYSICAL THERAPY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-398-0929
Mailing Address - Street 1:150 W 21ST ST
Mailing Address - Street 2:6G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3204
Mailing Address - Country:US
Mailing Address - Phone:516-398-0929
Mailing Address - Fax:
Practice Address - Street 1:150 W 21ST ST
Practice Address - Street 2:6G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3204
Practice Address - Country:US
Practice Address - Phone:516-398-0929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-04
Last Update Date:2015-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033041225100000X
NY035530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty