Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Legacy Physiatry Group Pennsylvania, LLC

Organization Internal Medicine Physician · NPI 1477940740

Legacy Physiatry Group Pennsylvania, LLC is an Internal Medicine Physician in Bala Cynwyd, Pennsylvania. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

150 Monument Rd Ste 207
Bala Cynwyd, PA 19004-1702
Phone: (972) 372-1663
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X
Internal Medicine Physician Taxonomy 207R00000X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1477940740
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vivek Sastry — President/Ceo · (972) 372-1663
Other names Legacy Physiatry Group
NPI enumeratedApril 23, 2015
Last updated in NPPESApril 23, 2015
Mailing address850 Central Pkwy E, Suite 275, Plano, TX 75074-5561

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