Proactive Pt LLC
Physical Therapist in Bronx, NY. Organization (NPI-2).
NPI number1063281145
StatusActive
Last updated in NPPESDec 29, 2023
Details
- NPI
- 1063281145
- Entity type
- Organization (NPI-2)
- Legal business name
- Proactive Pt LLC
- Organization subpart
- No
- Enumeration date
- Dec 29, 2023
- Certification date
- Dec 29, 2023
- Last updated
- Dec 29, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Practice location
1480 Williamsbridge RdBronx, NY 10461-2505
Phone 214-606-4154
Mailing address
77 Sherman Pl Apt 3Jersey City, NJ 07307-3733
Phone 214-606-4154
Authorized official
Suruch Rashmikant Patel
Home Health Physical Therapist
2146064154
Is something wrong?
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