Provider Demographics
NPI:1053021063
Name:KEYSTONE PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:KEYSTONE PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CARIN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CAPPADOCIA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:518-573-3971
Mailing Address - Street 1:26 LORI JEAN PL
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12182-2449
Mailing Address - Country:US
Mailing Address - Phone:518-573-3971
Mailing Address - Fax:518-304-6006
Practice Address - Street 1:12 METRO PARK RD STE 208
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1139
Practice Address - Country:US
Practice Address - Phone:518-304-6006
Practice Address - Fax:518-304-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty