| Organization Name: | PROCORE PHYSICAL THERAPY P.C. |
| NPI Number: | 1154701563 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY STEMKOWSKI (PRESIDENT) |
| Mailing Address: | 47 Route 303 Tappan |
| State: | NY US |
| Postal Code: | 109832805 |
| Phone Number: | 8458482506 |
| Fax Number: | |
| NPI Enumeration Date: | 06/02/2015 |
| NPI Last Update Date: | 06/02/2015 |
| 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: | |