| Organization Name: | PROCORE PHYSICAL THERAPY P.C. |
| NPI Number: | 1013219047 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY STEMKOWSKI (PRESIDENT/PHYSICAL THERAPIST) |
| Mailing Address: | 430 Nanuet Mall S Nanuet |
| State: | NY US |
| Postal Code: | 109542710 |
| Phone Number: | 8455890556 |
| Fax Number: | 8455890558 |
| NPI Enumeration Date: | 11/24/2010 |
| NPI Last Update Date: | 11/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 018525-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |