360 Physical Therapy Wellness PC
Organization Active NPI Physical Therapist · New York, NY
NPI 1053906271 · NPPES record last updated Jun 17, 2024
Key facts
- NPI
- 1053906271
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- 360 PHYSICAL THERAPY WELLNESS PC
- Practice address
- 51 E 125TH St FRNT 3
New York, NY 10035-1688 - Phone
- (646) 397-3454
- NPI assigned
- Mar 9, 2021
- Organization subpart
- No
Authorized official
- Name
- Jack Zuckerman, DPT
- Title
- President
- Phone
- (646) 397-3454
Practitioners 3
-
Jack Zuckerman, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220112002274 | NY | Part B Supplier - Clinic/Group Practice | 4284026774 |
Receives reassigned benefits from 3 practitioners Practice locations: New York, NY |
National Provider Directory
Locations
51 E 125th St
Frnt 3
New York, NY 10035
Phone (646) 397-3454
51 E 125th St
Ste 3E
New York, NY 10035
Phone (646) 397-3454
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
51 E 125TH St FRNT 3
New York, NY 10035-1688
Mailing address
51 E 125TH St Ste 3E
New York, NY 10035-1685
Other providers in New York, NY
- 3340 Broadway Pharmacy 2 Inc
- 337 Lenox Medical Services, P.C.
- 34TH Street Dental Associates PC
- 360 Complete Medical PC
- 360 Medical Consulting LLC
- 360 Physician Assistant Services, PLLC
- 360 Psychological Services
- 370 Pharmacy Corp
- 38 W Physical Therapy
- 3801 Broadway RX LLC
All providers in New York, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.