| Organization Name: | FITNESS AND RECOVERY MEDICAL PRACTICE |
| NPI Number: | 1144633637 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MACK LEE SULLIVAN (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 369 White Plains Rd Eastchester |
| State: | NY US |
| Postal Code: | 107092805 |
| Phone Number: | 9143953691 |
| Fax Number: | 9143953693 |
| NPI Enumeration Date: | 06/03/2014 |
| NPI Last Update Date: | 06/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 037690 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |