Provider Demographics
NPI:1447346309
Name:PHYSICAL THERAPY OF HARLEM, LLP
Entity type:Organization
Organization Name:PHYSICAL THERAPY OF HARLEM, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTOLO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-996-3303
Mailing Address - Street 1:1783A MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-4537
Mailing Address - Country:US
Mailing Address - Phone:212-996-3303
Mailing Address - Fax:212-996-9686
Practice Address - Street 1:1783A MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-4537
Practice Address - Country:US
Practice Address - Phone:212-996-3303
Practice Address - Fax:212-996-9686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ3W7U1Medicare ID - Type UnspecifiedFACILITY PROVIDER NUMBER