Provider Demographics
NPI:1588890313
Name:GOSHEN PHYSICAL THERAPY P.C
Entity type:Organization
Organization Name:GOSHEN PHYSICAL THERAPY P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:IPAYE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-655-6200
Mailing Address - Street 1:710 E 217TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-5802
Mailing Address - Country:US
Mailing Address - Phone:718-655-6200
Mailing Address - Fax:
Practice Address - Street 1:710 EAST 217TH STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-655-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100001524Medicare PIN