Provider Demographics
NPI:1538238266
Name:BEYOND BASICS PHYSICAL THERAPY
Entity type:Organization
Organization Name:BEYOND BASICS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:212-354-2622
Mailing Address - Street 1:110 E 42ND ST
Mailing Address - Street 2:SUITE 1504
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5611
Mailing Address - Country:US
Mailing Address - Phone:212-354-2622
Mailing Address - Fax:212-354-2752
Practice Address - Street 1:110 E 42ND ST
Practice Address - Street 2:SUITE 1504
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5611
Practice Address - Country:US
Practice Address - Phone:212-354-2622
Practice Address - Fax:212-354-2752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQB3941Medicare PIN
NYQ22B91Medicare PIN
NYQ3W9Y1Medicare PIN