Provider Demographics
NPI:1164297198
Name:GENERATIONAL PHYSICAL THERAPY
Entity type:Organization
Organization Name:GENERATIONAL PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:APOSTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-379-5810
Mailing Address - Street 1:233 BERTRAM PL
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-4201
Mailing Address - Country:US
Mailing Address - Phone:631-379-5810
Mailing Address - Fax:
Practice Address - Street 1:233 BERTRAM PL
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-4201
Practice Address - Country:US
Practice Address - Phone:631-379-5810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty