Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Great Western Physical Therapy PC

Organization Physical Therapy Clinic/Center · NPI 1174162440

Great Western Physical Therapy PC is a Physical Therapy Clinic/Center in Astoria, New York. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3175 29th St Apt A7
Astoria, NY 11106-3328
Phone: (929) 340-1606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X

Record details

NPI number1174162440
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Davydov — Physical Therapist · (929) 340-1606
NPI enumeratedJanuary 3, 2020
Last updated in NPPESJanuary 3, 2020
Certification dateJanuary 3, 2020
Mailing address3175 29th St Apt A7, Astoria, NY 11106-3328

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