Provider Demographics
NPI:1750369070
Name:PHYSICAL THERAPY AT BRIARCLIFF AND JEFFERSON VALLEY
Entity type:Organization
Organization Name:PHYSICAL THERAPY AT BRIARCLIFF AND JEFFERSON VALLEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MERYLE
Authorized Official - Middle Name:HELENE
Authorized Official - Last Name:RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PTMS
Authorized Official - Phone:914-762-2222
Mailing Address - Street 1:600 BANK RD
Mailing Address - Street 2:PO BOX 241
Mailing Address - City:JEFFERSON VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10535-1511
Mailing Address - Country:US
Mailing Address - Phone:914-245-8807
Mailing Address - Fax:914-245-9015
Practice Address - Street 1:600 BANK RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10535-1511
Practice Address - Country:US
Practice Address - Phone:914-245-8807
Practice Address - Fax:914-245-9015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ5W241Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER