Provider Demographics
NPI:1871900878
Name:MY PT
Entity type:Organization
Organization Name:MY PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-261-0067
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-0122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 WILLOWBROOK DR
Practice Address - Street 2:
Practice Address - City:NORTH CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-4409
Practice Address - Country:US
Practice Address - Phone:201-694-7738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty