Provider Demographics
NPI:1104948371
Name:HEALING SOLUTIONS PHYSICAL THERAPY, PLLC.
Entity type:Organization
Organization Name:HEALING SOLUTIONS PHYSICAL THERAPY, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:518-561-6888
Mailing Address - Street 1:882 MASON ST
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-2700
Mailing Address - Country:US
Mailing Address - Phone:518-561-6888
Mailing Address - Fax:
Practice Address - Street 1:882 MASON ST
Practice Address - Street 2:
Practice Address - City:MORRISONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12962-2700
Practice Address - Country:US
Practice Address - Phone:518-561-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008917-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY795859OtherMVP
NY000415107001OtherBLUESHIELD OF NENY
NYQ36A3OtherEMPIRE BC
NY01021181Medicaid
NY01021181Medicaid