Provider Demographics
NPI:1063054567
Name:38 W PHYSICAL THERAPY
Entity type:Organization
Organization Name:38 W PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KRISTINE MAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARCON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:848-565-4819
Mailing Address - Street 1:156 WILLIAM ST RM 801
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-0083
Mailing Address - Country:US
Mailing Address - Phone:848-565-4819
Mailing Address - Fax:646-559-1358
Practice Address - Street 1:156 WILLIAM ST RM 801
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-0083
Practice Address - Country:US
Practice Address - Phone:848-565-4819
Practice Address - Fax:646-559-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty