| Physiatry PLLC | |
|
233 N Main St New City NY 10956-4018 | |
| (201) 839-2762 | |
| Not Available |
| Full Name | Physiatry PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 233 N Main St, New City, New York |
| Authorized Official Name and Position | Susanna Shepper (OWNER) |
| Authorized Official Contact | 7187533912 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physiatry PLLC 75 Dudley Dr Bergenfield NJ 07621-2613 | Physiatry PLLC 233 N Main St New City NY 10956-4018 Ph: (201) 839-2762 |
| NPI Number | 1811737455 |
|---|---|
| Provider Enumeration Date | 05/30/2024 |
| Last Update Date | 05/30/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 7810439528 |
|---|---|
| Medicare Enrollment ID | O20240610003177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811737455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| Provider Name | Susanna Shepper |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1164792420 PECOS PAC ID: 3274758115 Enrollment ID: I20140708002189 |
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