Provider Demographics
NPI:1720501174
Name:UNITED PHYSICAL THERAPY
Entity Type:Organization
Organization Name:UNITED PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT, MS. DPT.
Authorized Official - Prefix:DR
Authorized Official - First Name:OSAMA
Authorized Official - Middle Name:E
Authorized Official - Last Name:OMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:646-996-7095
Mailing Address - Street 1:684 OCEAN TER
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4538
Mailing Address - Country:US
Mailing Address - Phone:646-996-7095
Mailing Address - Fax:
Practice Address - Street 1:684 OCEAN TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4538
Practice Address - Country:US
Practice Address - Phone:646-996-7095
Practice Address - Fax:800-722-4260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency