Provider Demographics
NPI:1265519904
Name:BARCLAY HEIGHTS PHYSICAL THERAPY, PC
Entity type:Organization
Organization Name:BARCLAY HEIGHTS PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SPERL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:845-247-2351
Mailing Address - Street 1:3165 HIGHWAY 9W
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-5220
Mailing Address - Country:US
Mailing Address - Phone:845-247-2351
Mailing Address - Fax:845-247-2353
Practice Address - Street 1:3165 HIGHWAY 9W
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-5220
Practice Address - Country:US
Practice Address - Phone:845-247-2351
Practice Address - Fax:845-247-2353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021041-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ6W7D1Medicare ID - Type UnspecifiedBHPTPC GROUP