| Organization Name: | PUTNAM PHYSICAL MEDICINE AND REHABILITATION |
| NPI Number: | 1851454847 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORELEI DAVIDSON (PRESIDENT) |
| Mailing Address: | 954 Route 6 Mahopac |
| State: | NY US |
| Postal Code: | 105411722 |
| Phone Number: | 8456282004 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | 206144 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |