EAST SIDE SPORTS PHYSICAL THERAPY, P.C. , NPI 1093788135 — NEW YORK (NY)

NPI 1093788135

13+ Years Experience Organization

EAST SIDE SPORTS PHYSICAL THERAPY, P.C.

02.09.2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1093788135
NPI NUMBER

About EAST SIDE SPORTS PHYSICAL THERAPY, P.C.

EAST SIDE SPORTS PHYSICAL THERAPY, P.C. is a provider established in NEW YORK, NY. The NPI number of EAST SIDE SPORTS PHYSICAL THERAPY, P.C. is 1093788135 and was assigned on 02.09.2006. The practitioners primary taxonomy code is: 261QP2000X with license number: 5564 NY .

Mailing address

  • City: NEW YORK
  • State: NY
  • Postal code: 100282902
  • Phone: 2125700209
  • Fax: 2125700197
  • Address: 244 E 84TH ST
  • Address 2: 3 FLOOR

Primary Practice Address

  • Region : NEW YORK, NY
  • NPI : 1093788135
  • Phone : 2125700209
  • Fax : 2125700197
  • Postalcode : 100282902
  • Address : 244 E 84TH ST 3 FLOOR

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QP2000X
  • License number: 5564
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • EAST SIDE SPORTS PHYSICAL THERAPY, P.C.
  • Address : 244 E 84TH ST 3 FLOOR
  • Region : NEW YORK, NY
  • NPI : 1093788135
  • Phone : 2125700209
  • Fax : 2125700197
  • Postalcode : 100282902

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 2125700209
  • Title or position : PRESIDENT
  • Credentials : P.T.

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address244 E 84TH ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address3 FLOOR
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNEW YORK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code100282902
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2125700209
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2125700197
The fax number associated with the location address of the provider being identified.
NPI1093788135
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QP2000X
Provider Enumeration Date02.09.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)EAST SIDE SPORTS PHYSICAL THERAPY, P.C.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address244 E 84TH ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing Address3 FLOOR
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameNEW YORK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code100282902
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2125700209
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number2125700197
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameSARANITI
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameANTHONY
The first name of the authorized official
Authorized Official Middle NameJ
The middle name of the authorized official
Authorized Official Title or PositionPRESIDENT
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Credential TextP.T.
Authorized Official Credential Text
Authorized Official Telephone Number2125700209
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QP2000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Provider License Number 15564
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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