Provider Demographics
NPI:1306921341
Name:JOHN P. STORCK, PT P.C.
Entity type:Organization
Organization Name:JOHN P. STORCK, PT P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:STORCK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS
Authorized Official - Phone:914-941-2674
Mailing Address - Street 1:141 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1459
Mailing Address - Country:US
Mailing Address - Phone:914-941-2674
Mailing Address - Fax:914-941-2675
Practice Address - Street 1:141 N STATE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1459
Practice Address - Country:US
Practice Address - Phone:914-941-2674
Practice Address - Fax:914-941-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0173882251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000077031OtherGHI HMO
NY1764692OtherUNITED HEALTHCARE
NY971839OtherGALAXY HEALTH NETWORK
NY6697949OtherGHI PPO
NY1000039296OtherAFFINITY
NY02236551Medicaid
NY21239636646OtherBEECHSTREET
NY21570OtherHUDSON HEALTH PLAN
NY713324OtherMVP
NYQ04A5OtherBLUE CROSS/ BLUE SHIELD
NY=========OtherCIGNA
NY=========OtherMAGNACARE
NY=========OtherMULTIPLAN
NY02236551Medicaid
NY713324OtherMVP
NY=========OtherPOMCO
NYQ04A5OtherBLUE CROSS/ BLUE SHIELD
NY=========OtherPHCS
NY=========OtherHIP
NY02236551Medicaid