Provider Demographics
NPI:1720141690
Name:ORTHOCARE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ORTHOCARE PHYSICAL THERAPY
Other - Org Name:ORTHOCARE PHYSICAL THERAPY AND SPORTS REHABILITATION PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENITO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIAMPAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS, MTC
Authorized Official - Phone:914-693-2350
Mailing Address - Street 1:1053 SAW MILL RIVER RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-1048
Mailing Address - Country:US
Mailing Address - Phone:914-693-2350
Mailing Address - Fax:914-693-7661
Practice Address - Street 1:1053 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 105
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1048
Practice Address - Country:US
Practice Address - Phone:914-693-2350
Practice Address - Fax:914-693-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012170-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQN822-2OtherBCBS
NYQN822-2OtherBCBS