Provider Demographics
NPI:1962802827
Name:APOLLO PHYSICAL REHABILITATION LLP
Entity type:Organization
Organization Name:APOLLO PHYSICAL REHABILITATION LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:C
Authorized Official - Last Name:PENNELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:917-299-3177
Mailing Address - Street 1:222 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6308
Mailing Address - Country:US
Mailing Address - Phone:203-674-9540
Mailing Address - Fax:203-674-9548
Practice Address - Street 1:222 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6308
Practice Address - Country:US
Practice Address - Phone:203-674-9540
Practice Address - Fax:203-674-9548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT111N00000X
CT03846489225100000X
CT000430225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty