Provider Demographics
NPI:1932827524
Name:JPG PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:JPG PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:929-328-7233
Mailing Address - Street 1:15 JOAN CT
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-1212
Mailing Address - Country:US
Mailing Address - Phone:929-328-7233
Mailing Address - Fax:
Practice Address - Street 1:1115 BROADWAY STE 1042
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3450
Practice Address - Country:US
Practice Address - Phone:929-328-7233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty