Provider Demographics
NPI:1528749496
Name:IVYREHAB PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:IVYREHAB PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PAYER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-678-6119
Mailing Address - Street 1:1311 MAMARONECK AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5224
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:
Practice Address - Street 1:80 ROUTE 6 UNIT 701702
Practice Address - Street 2:
Practice Address - City:BALDWIN PLACE
Practice Address - State:NY
Practice Address - Zip Code:10505-1026
Practice Address - Country:US
Practice Address - Phone:845-875-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management