Provider Demographics
NPI:1649424748
Name:NEW FOCUS PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:NEW FOCUS PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:VANKEMPEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-326-9065
Mailing Address - Street 1:1 AGWAY DR
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-9637
Mailing Address - Country:US
Mailing Address - Phone:518-326-9065
Mailing Address - Fax:518-326-9064
Practice Address - Street 1:1 AGWAY DR
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-9637
Practice Address - Country:US
Practice Address - Phone:518-326-9065
Practice Address - Fax:518-326-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029685261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy