Provider Demographics
NPI:1194055723
Name:PROGRESSIVE PHYSICAL THERAPY SERVICES OF NEW YORK, PLLC
Entity type:Organization
Organization Name:PROGRESSIVE PHYSICAL THERAPY SERVICES OF NEW YORK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-242-8270
Mailing Address - Street 1:40 SCENIC HILLS DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3723
Mailing Address - Country:US
Mailing Address - Phone:845-242-8270
Mailing Address - Fax:845-215-0070
Practice Address - Street 1:1987 STATE ROUTE 52 EAST
Practice Address - Street 2:SUITE 11
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-8317
Practice Address - Country:US
Practice Address - Phone:845-292-8580
Practice Address - Fax:845-292-8909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0106642251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty