Provider Demographics
NPI:1104159714
Name:STRIDE PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:STRIDE PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:212-255-6355
Mailing Address - Street 1:89 5TH AVE
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3020
Mailing Address - Country:US
Mailing Address - Phone:212-255-6355
Mailing Address - Fax:212-255-8355
Practice Address - Street 1:89 5TH AVE
Practice Address - Street 2:SUITE 1002
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3020
Practice Address - Country:US
Practice Address - Phone:212-255-6355
Practice Address - Fax:212-255-8355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty