Provider Demographics
NPI:1194930511
Name:PARK NORTH PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:PARK NORTH PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:MORJARIA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-222-6525
Mailing Address - Street 1:233 LENOX AVE
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6498
Mailing Address - Country:US
Mailing Address - Phone:212-222-6525
Mailing Address - Fax:646-497-0938
Practice Address - Street 1:233 LENOX AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6498
Practice Address - Country:US
Practice Address - Phone:212-222-6525
Practice Address - Fax:646-497-0938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019912261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0030380OtherORTHONET
0030380OtherORTHONET