Provider Demographics
NPI:1134252257
Name:PAMELA MORRISON PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:PAMELA MORRISON PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:MORRISON
Authorized Official - Last Name:WILES
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, IMTC
Authorized Official - Phone:212-362-3022
Mailing Address - Street 1:140 WEST END AVE
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6131
Mailing Address - Country:US
Mailing Address - Phone:212-362-3022
Mailing Address - Fax:212-362-8760
Practice Address - Street 1:140 WEST END AVE
Practice Address - Street 2:SUITE 1K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6131
Practice Address - Country:US
Practice Address - Phone:212-362-3022
Practice Address - Fax:212-362-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013586-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQK8701Medicare PIN