Provider Demographics
NPI:1386941870
Name:FLEMING PHYSICAL THERAPY CONSULTANT PC
Entity type:Organization
Organization Name:FLEMING PHYSICAL THERAPY CONSULTANT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:518-857-7528
Mailing Address - Street 1:5010 STATE HIGHWAY 30 STE 101
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7532
Mailing Address - Country:US
Mailing Address - Phone:518-212-6291
Mailing Address - Fax:518-212-2222
Practice Address - Street 1:5010 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7532
Practice Address - Country:US
Practice Address - Phone:518-212-6291
Practice Address - Fax:518-212-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty