Provider Demographics
NPI:1427758762
Name:NORA B, PT PEDIATRIC PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:NORA B, PT PEDIATRIC PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-755-8910
Mailing Address - Street 1:1233 20TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11835 W OLYMPIC BLVD STE 925E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-5090
Practice Address - Country:US
Practice Address - Phone:917-755-8910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty