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Organization
MOUNTAIN PHYSICAL THERAPY
Active
Organization
MOUNTAIN PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN MARISKI P.T. (OWNER)
(845) 796-2470
Entity
Organization
Contact information
Practice address
427 BROADWAY, SUITE 3, MONTICELLO, NY 12701-1742
(845) 796-2470
(845) 796-1420
Mailing address
427 BROADWAY, SUITE 3, MONTICELLO, NY 12701-1742
(845) 796-2470
(845) 796-1420
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151358
WELLCARE
NY
01
—
4623553
AETNA
NY
01
—
6604181
GHI
NY
Enumeration date
10/05/2006
Last updated
08/22/2020
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