Provider Demographics
NPI:1023610730
Name:BODHIZONE FOR HUMAN PERFORMANCE & SPORTS PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:BODHIZONE FOR HUMAN PERFORMANCE & SPORTS PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT ATC DMQ
Authorized Official - Phone:516-375-9776
Mailing Address - Street 1:1301 AVENUE OF THE AMERICAS
Mailing Address - Street 2:PARAMOUNT WELLNESS / CONCOURSE LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6022
Mailing Address - Country:US
Mailing Address - Phone:347-507-5877
Mailing Address - Fax:347-507-5877
Practice Address - Street 1:1301 AVENUE OF THE AMERICAS
Practice Address - Street 2:PARAMOUNT WELLNESS / CONCOURSE LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6022
Practice Address - Country:US
Practice Address - Phone:347-507-5877
Practice Address - Fax:347-507-5877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy