Provider Demographics
NPI:1427299254
Name:FAHRENHEIT PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:FAHRENHEIT PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MADDALONE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-441-5440
Mailing Address - Street 1:38 HARBOR PARK DR
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4602
Mailing Address - Country:US
Mailing Address - Phone:516-441-5440
Mailing Address - Fax:516-441-5441
Practice Address - Street 1:38 HARBOR PARK DR
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-4602
Practice Address - Country:US
Practice Address - Phone:516-441-5440
Practice Address - Fax:516-441-5441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022786261QP2000X
NY029947261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400011199Medicare UPIN
A100001215Medicare UPIN