Provider Demographics
NPI:1720517154
Name:WESTCHESTER PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:WESTCHESTER PHYSICAL THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:RADEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:929-335-3478
Mailing Address - Street 1:495 CENTRAL PARK AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1038
Mailing Address - Country:US
Mailing Address - Phone:929-335-3478
Mailing Address - Fax:
Practice Address - Street 1:495 CENTRAL PARK AVE
Practice Address - Street 2:STE 206
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10804
Practice Address - Country:US
Practice Address - Phone:929-335-3478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0168741225100000X
NY016874-12251P0200X
NY016871-12251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty