Stone Ridge Physical Therapy, PC
Organization Active NPI Specialist · Stone Ridge, NY
NPI 1164595294 · NPPES record last updated May 18, 2011
Key facts
- NPI
- 1164595294
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 017511 (NY)
- Legal business name
- STONE RIDGE PHYSICAL THERAPY, PC
- Practice address
- 3555 Main St
Stone Ridge, NY 12484-5612 - Phone
- (845) 687-8806
- NPI assigned
- Nov 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Robert Klein
- Title
- President
- Phone
- (845) 687-8806
Practitioners 3
-
Daniel Hoyt, PT
-
Robert Klein, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110518000572 | NY | Part B Supplier - Clinic/Group Practice | 5395635387 |
Receives reassigned benefits from 2 practitioners Practice locations: Saugerties, NY; Stone Ridge, NY |
National Provider Directory
Locations
3555 Main St
Stone Ridge, NY 12484
Phone (845) 687-8806
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 017511 | NY | Yes |
Addresses
Primary practice location
3555 Main St
Stone Ridge, NY 12484-5612
Mailing address
3555 Main St
PO Box 266
Stone Ridge, NY 12484-5612
Other providers in Stone Ridge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2011. 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.