Provider Demographics
NPI:1679167936
Name:GOOD LIFE PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:GOOD LIFE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:914-200-1475
Mailing Address - Street 1:55 S BROADWAY STE 2
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-4004
Mailing Address - Country:US
Mailing Address - Phone:914-200-1475
Mailing Address - Fax:
Practice Address - Street 1:55 SOUTH BROADWAY
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-4520
Practice Address - Country:US
Practice Address - Phone:914-200-1475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty