Provider Demographics
NPI:1245252923
Name:CHAMBERLAIN PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:CHAMBERLAIN PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-855-2661
Mailing Address - Street 1:4 OAK ST STE B
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1024
Mailing Address - Country:US
Mailing Address - Phone:845-855-2661
Mailing Address - Fax:845-855-2672
Practice Address - Street 1:4 OAK ST STE B
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-1024
Practice Address - Country:US
Practice Address - Phone:845-855-2661
Practice Address - Fax:845-855-2672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014258-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2454907OtherAETNA
NY437299OtherMVP
NYQ49431OtherMEDICARE ID-TYPE UNSPECIFIED
NYP2107704OtherOXFORD
NY823080OtherMANAGED PHYSICAL NETWORK
NY0104435OtherGHI, PPO
NY000000105119OtherGHI, HMO
NYQ49431OtherMEDICARE ID-TYPE UNSPECIFIED