Organization
FITNESS FORUM PHYSICAL AND OCCUPATIONAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L LINKIEWICZ PT (PRESIDENT)
(315) 478-0380
Entity
Organization
Contact information
Practice address
5719 WIDEWATERS PKWY, DE WITT, NY 13214-1985
(315) 478-0380
(315) 478-0388
Mailing address
231 WALTON ST, SUITE 200, SYRACUSE, NY 13202-1885
(315) 478-0380
(315) 478-0388
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
011796-1
NY
225XH1200X
Hand Occupational Therapist
Primary
007223-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BA0683
MEDICARE GROUP
NY
Enumeration date
06/08/2011
Last updated
07/12/2011
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