Provider Demographics
NPI:1487271755
Name:CYPRESS PT NORTH LLC
Entity type:Organization
Organization Name:CYPRESS PT NORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DPT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:PECORARO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:985-351-6289
Mailing Address - Street 1:19065 DR JOHN LAMBERT DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-0996
Mailing Address - Country:US
Mailing Address - Phone:985-351-6289
Mailing Address - Fax:985-314-5994
Practice Address - Street 1:19065 DR JOHN LAMBERT DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-0996
Practice Address - Country:US
Practice Address - Phone:985-351-6289
Practice Address - Fax:985-314-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty