Provider Demographics
NPI:1306050604
Name:MANHATTAN PHYSICAL MEDICINE & REHABILITATION, PLLC
Entity type:Organization
Organization Name:MANHATTAN PHYSICAL MEDICINE & REHABILITATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-472-0077
Mailing Address - Street 1:133 E 58TH ST STE 811
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1299
Mailing Address - Country:US
Mailing Address - Phone:212-472-0077
Mailing Address - Fax:212-472-4127
Practice Address - Street 1:133 E 58TH ST STE 811
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-472-0077
Practice Address - Fax:212-472-4127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW1L061Medicare PIN
NY02708AMedicare PIN