FAIRWAY PHYSICAL THERAPY NORTH
NPI 1053503185
Clinic/Center - Physical Therapy in Central Square, NY

Active since August 13, 2007
573 S MAIN ST, CENTRAL SQUARE, NY 13036(315) 676-3826(315) 676-3402 Get Directions Write a Review

NPPES record last updated: November 21, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fairway Physical Therapy North NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRWAY PHYSICAL THERAPY NORTH (NPI 1053503185) is a healthcare organization registered as a physical therapy in Central Square, New York and active in the NPI registry since August 2007. The organization lists Nicole Blythe Derue, President, as its authorized official.

NPPES Registry Identity

NPI1053503185
Entity TypeOrganization
Primary Taxonomy261QP2000X
Legal Business NameNICOLE DERUE PHYSICAL THERAPY P.C.
Location Address573 S MAIN STCentral Square, NY 13036-9785
Mailing Address573 S Main StCentral Square, NY 13036-9785 · (315) 676-3826 · Fax (315) 676-3402
Fax(315) 676-3402
Organization SubpartNo
Authorized OfficialNicole Blythe DeruePresident · (315) 676-3826
Enumeration DateAugust 13, 2007
Last NPPES UpdateNovember 21, 2007
NPI 1053503185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Physical TherapyAmbulatory Health Care Facilities
Taxonomy Code261QP2000X
License Licensed in NY · 0590998
Definition
An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.
573 S MAIN ST, Central Square, NY 13036

Other Names 1

Doing Business AsFairway Physical Therapy North

Other Identifiers 1

Medicare PINBA1215NY

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
573 S MAIN ST
CENTRAL SQUARE, NY 13036

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Derue Physical Therapy P.C.'s NPI number?

The NPI number for Nicole Derue Physical Therapy P.C. is 1053503185. It was assigned to this organization in the NPPES registry on August 13, 2007. The provider is doing business as Fairway Physical Therapy North.

Where is Nicole Derue Physical Therapy P.C. located?

Nicole Derue Physical Therapy P.C. is located at 573 S Main St, Central Square, NY 13036. The listed phone number is (315) 676-3826.

What is Nicole Derue Physical Therapy P.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.

When was this NPI record last updated?

The NPPES record for Nicole Derue Physical Therapy P.C. was last updated on November 21, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.