Provider Demographics
NPI:1124529920
Name:PHYSICAL THERAPY OF HARLEM
Entity type:Organization
Organization Name:PHYSICAL THERAPY OF HARLEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:212-996-3303
Mailing Address - Street 1:1400 5TH AVE FRNT 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2584
Mailing Address - Country:US
Mailing Address - Phone:212-996-3303
Mailing Address - Fax:212-996-9686
Practice Address - Street 1:1400 5TH AVE FRNT 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2584
Practice Address - Country:US
Practice Address - Phone:212-996-3303
Practice Address - Fax:212-996-9686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03099149Medicaid