Primary Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRIMARY PHYSICAL THERAPY PLLC

Practice address

792 N Main St
Ste 100C
North Syracuse, NY 13212-1644

Phone

(315) 458-2552

Fax

(315) 458-2575

NPI assigned

Mar 10, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey W Hathaway, PT

Title

Owner/PT

Phone

(315) 451-6541

Specialties & licenses 1

Addresses

Other names 1

• PROActive Physical Therapy Doing business as

Locations

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1164745774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD",
            "address_2": "STE 2",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784",
            "telephone_number": "315-451-6541",
            "fax_number": "315-451-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST",
            "address_2": "STE 100C",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121644",
            "telephone_number": "315-458-2552",
            "fax_number": "315-458-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "315-451-6541",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROActive Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Podiatry Services of Central New York P C
• Podiatry Services of Central New York, PC
• Mark S Post, DPM
• Derek Powell
• Jennifer Prall
• Primary Physical Therapy PLLC
• Gregory 'Greg' Procopio, N.P.
• Mary Jo Proietta-Halpern, LCSW-R
• Noelle Pudney
• William Michael Pullano, DDS

• Physical Therapist in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.