Provider Demographics
NPI:1316079890
Name:WESTCHESTER PHYSICAL THERAPY ASSOCIATES PC
Entity type:Organization
Organization Name:WESTCHESTER PHYSICAL THERAPY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PENNACCHIO-FERRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-997-6970
Mailing Address - Street 1:185 MAPLE AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4776
Mailing Address - Country:US
Mailing Address - Phone:914-997-6970
Mailing Address - Fax:914-946-4619
Practice Address - Street 1:185 MAPLE AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4776
Practice Address - Country:US
Practice Address - Phone:914-997-6970
Practice Address - Fax:914-946-4619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005547-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0075138OtherGHI
NY0119101OtherORTHONET-HEALTHNET
NY806391OtherACN
NYA395362OtherOXFORD
NY1403948OtherUNITED HEALTH CARE
NY005547OtherHIP
NY1403948OtherUNITED HEALTH CARE
NYQ52241Medicare ID - Type Unspecified