Provider Demographics
NPI:1871869610
Name:SPORTSLABNYC, LLC
Entity type:Organization
Organization Name:SPORTSLABNYC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NAZEER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-764-0270
Mailing Address - Street 1:15 WEST 39TH STREET
Mailing Address - Street 2:FLOOR 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:212-764-0270
Mailing Address - Fax:212-764-0275
Practice Address - Street 1:15 WEST 39TH STREET
Practice Address - Street 2:FLOOR 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:212-764-0270
Practice Address - Fax:212-764-0275
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPORTSLABNYC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-27
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty