Provider Demographics
NPI:1194993675
Name:WENNING PHYSICAL THERAPY
Entity type:Organization
Organization Name:WENNING PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:BARTHOLOMEW
Authorized Official - Last Name:WENNING
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:646-712-2064
Mailing Address - Street 1:152 E 73RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4362
Mailing Address - Country:US
Mailing Address - Phone:646-712-2064
Mailing Address - Fax:212-861-1014
Practice Address - Street 1:152 E 73RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4362
Practice Address - Country:US
Practice Address - Phone:646-712-2064
Practice Address - Fax:212-861-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026757-1320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities