Provider Demographics
NPI:1558731976
Name:POTTS, FLORENCE M J (PT)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:M J
Last Name:POTTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HELLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5209
Mailing Address - Country:US
Mailing Address - Phone:845-658-7763
Mailing Address - Fax:
Practice Address - Street 1:2032 ROUTE 213 ST
Practice Address - Street 2:
Practice Address - City:RIFTON
Practice Address - State:NY
Practice Address - Zip Code:12471-7700
Practice Address - Country:US
Practice Address - Phone:845-658-8961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015109225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist