Provider Demographics
NPI:1831430933
Name:DEELEY PHYSICAL THERAPY, PC
Entity type:Organization
Organization Name:DEELEY PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:607-768-2262
Mailing Address - Street 1:709 CONKLIN RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-2766
Mailing Address - Country:US
Mailing Address - Phone:607-237-0148
Mailing Address - Fax:607-697-2035
Practice Address - Street 1:709 CONKLIN RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-2766
Practice Address - Country:US
Practice Address - Phone:607-237-0148
Practice Address - Fax:607-697-2035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020105-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy