Provider Demographics
NPI:1841292430
Name:ADVANCED PHYSICAL THERAPY OF ALBANY, PC
Entity type:Organization
Organization Name:ADVANCED PHYSICAL THERAPY OF ALBANY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:518-443-2279
Mailing Address - Street 1:747 MADISON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3392
Mailing Address - Country:US
Mailing Address - Phone:518-443-2279
Mailing Address - Fax:518-443-7246
Practice Address - Street 1:747 MADISON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3392
Practice Address - Country:US
Practice Address - Phone:518-443-2279
Practice Address - Fax:518-443-7246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0091Medicare PIN
NYBA0091Medicare PIN