Provider Demographics
NPI:1972749364
Name:ADK PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:ADK PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:315-896-5100
Mailing Address - Street 1:8022 STATE ROUTE 12
Mailing Address - Street 2:
Mailing Address - City:BARNEVELD
Mailing Address - State:NY
Mailing Address - Zip Code:13304-2512
Mailing Address - Country:US
Mailing Address - Phone:315-896-5100
Mailing Address - Fax:315-896-5102
Practice Address - Street 1:8022 STATE ROUTE 12
Practice Address - Street 2:
Practice Address - City:BARNEVELD
Practice Address - State:NY
Practice Address - Zip Code:13304-2512
Practice Address - Country:US
Practice Address - Phone:315-896-5100
Practice Address - Fax:315-896-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010569261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100000174Medicare PIN