Provider Demographics
NPI:1841354826
Name:CATSKILL PRIME PHYSICAL THERAPY ASSOCIATES
Entity type:Organization
Organization Name:CATSKILL PRIME PHYSICAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-444-4709
Mailing Address - Street 1:12 COVE CT
Mailing Address - Street 2:UNIT 1032
Mailing Address - City:ATHENS
Mailing Address - State:NY
Mailing Address - Zip Code:12015-3016
Mailing Address - Country:US
Mailing Address - Phone:518-444-4709
Mailing Address - Fax:
Practice Address - Street 1:12 COVE CT
Practice Address - Street 2:UNIT 1032
Practice Address - City:ATHENS
Practice Address - State:NY
Practice Address - Zip Code:12015-3016
Practice Address - Country:US
Practice Address - Phone:518-444-4709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty