Professional Orthopedic and Sports Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC

Practice address

185 Kisco Ave Ste 203
Mount Kisco, NY 10549-1409

Phone

(914) 302-4334

NPI assigned

Aug 9, 2017

Last updated

Apr 2, 2018By 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

Kathleen Brush

Title

Credentialing Manager

Phone

(631) 359-5859

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1770008906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 KISCO AVE STE 203",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491409",
            "telephone_number": "914-302-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "631-359-5859"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenore Powers, LCSW
• Practical Chiropractic, P.C.
• Premier Psychology Services, LLP
• Stephanie Marie Prevost, AUD
• Professional Occupational & Physical Therapy, PLLC
• Dana Protomastro, NP
• Melissa Marie Bennett Provost, FNP-BC
• Illyria Puharich, LCSW-R
• Manjju Agnes Pulickal, CRNA
• Susan Remmer Pulling, MS, RD

• Physical Therapist in Mount Kisco, NY
• Providers in Mount Kisco, 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 Apr 2, 2018; 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.