Provider Demographics
NPI:1780726125
Name:LOWER MANHATTAN PHYSICAL THERAPY
Entity type:Organization
Organization Name:LOWER MANHATTAN PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS,PT
Authorized Official - Phone:412-654-3212
Mailing Address - Street 1:944 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-2454
Mailing Address - Country:US
Mailing Address - Phone:718-230-0014
Mailing Address - Fax:718-230-1202
Practice Address - Street 1:944 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-2454
Practice Address - Country:US
Practice Address - Phone:718-230-0014
Practice Address - Fax:718-230-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
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