Provider Demographics
NPI:1427565910
Name:WESTBURY PHYSICAL THERAPY. PLLC
Entity type:Organization
Organization Name:WESTBURY PHYSICAL THERAPY. PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIBERTO CYRIS
Authorized Official - Middle Name:CYRIS
Authorized Official - Last Name:RAMOS III
Authorized Official - Suffix:III
Authorized Official - Credentials:PT
Authorized Official - Phone:516-279-6486
Mailing Address - Street 1:827 CARMAN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6429
Mailing Address - Country:US
Mailing Address - Phone:516-279-6486
Mailing Address - Fax:516-977-3512
Practice Address - Street 1:827 CARMAN AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6429
Practice Address - Country:US
Practice Address - Phone:516-279-6486
Practice Address - Fax:516-977-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022256261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02949177Medicaid