Provider Demographics
NPI:1467635136
Name:COWELL, GARRY (DPT)
Entity type:Individual
Prefix:MR
First Name:GARRY
Middle Name:
Last Name:COWELL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2175
Mailing Address - Country:US
Mailing Address - Phone:347-687-6713
Mailing Address - Fax:718-374-5398
Practice Address - Street 1:1055 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-2306
Practice Address - Country:US
Practice Address - Phone:646-351-6820
Practice Address - Fax:718-374-5398
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029931225100000X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1215159355OtherGROUP NPI #