Provider Demographics
NPI:1144268152
Name:PHYSICAL THERAPY ASSOCIATES OF NEW YORK LLC
Entity type:Organization
Organization Name:PHYSICAL THERAPY ASSOCIATES OF NEW YORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:C
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-366-4450
Mailing Address - Street 1:19 W 21ST ST
Mailing Address - Street 2:# 404
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6805
Mailing Address - Country:US
Mailing Address - Phone:212-366-4450
Mailing Address - Fax:212-202-3633
Practice Address - Street 1:19 W 21ST ST
Practice Address - Street 2:# 404
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6805
Practice Address - Country:US
Practice Address - Phone:212-366-4450
Practice Address - Fax:212-202-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P69535Medicare UPIN
NYQ2WBH1Medicare PIN