| Organization Name: | EMPIRE STATE PHYSICAL THERAPY, PC |
| NPI Number: | 1083805535 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYMOND LESLIE WONG-PAN (PHYSICAL THERAPIST) |
| Mailing Address: | 243 Main St Suite 40 New Paltz |
| State: | NY US |
| Postal Code: | 125611325 |
| Phone Number: | 8452551925 |
| Fax Number: | 8452551925 |
| NPI Enumeration Date: | 08/08/2007 |
| NPI Last Update Date: | 11/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 017188 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |