Provider Demographics
NPI:1962802199
Name:SHELBY PHYSICAL THERAPY SERVICES PC
Entity type:Organization
Organization Name:SHELBY PHYSICAL THERAPY SERVICES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-282-1050
Mailing Address - Street 1:637 CARDINAL RD
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-5201
Mailing Address - Country:US
Mailing Address - Phone:914-382-9301
Mailing Address - Fax:914-739-3140
Practice Address - Street 1:30 S HIGHLAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-4805
Practice Address - Country:US
Practice Address - Phone:914-382-9301
Practice Address - Fax:914-739-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty