Waldron Physiotherapy, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

021540-1 Issued in NY

Legal business name

WALDRON PHYSIOTHERAPY, PLLC

Practice address

103 Charlies PL
Chittenango, NY 13037-1080

Phone

(315) 503-1057

Fax

(315) 409-7708

NPI assigned

Mar 26, 2017

Last updated

Mar 26, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Keith P Waldron, PT, DPT

Title

Manager

Phone

(315) 503-1057

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490486400000",
    "number": "1053842575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130370480",
            "telephone_number": "315-503-1057",
            "fax_number": "315-409-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CHARLIES PL",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130371080",
            "telephone_number": "315-503-1057",
            "fax_number": "315-409-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDRON PHYSIOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-26",
        "last_updated": "2017-03-26",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "315-503-1057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "021540-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Chittenango, NY
• Providers in Chittenango, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.