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NPI Code Detail

MEDICARE: PRIORITY CARE PHYSICAL THERAPY PC

MEDICARE: PRIORITY CARE PHYSICAL THERAPY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center013032-1NY

General Provider Information

NPI Number : 1023010352
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIORITY CARE PHYSICAL THERAPY PC
Provider Business Mailing Address
First Line : 11 FRANKLIN PL
Second Line :
City : WOODMERE
State : NY
Zip : 11598-1216
Country : US
Telephone Number : 516-569-0373
Fax Number : 516-569-0374
Provider Business Practice Location Address
First Line : 11 FRANKLIN PL
Second Line :
City : WOODMERE
State : NY
Zip : 11598-1216
Country : US
Telephone Number : 516-569-0373
Fax Number : 516-569-0374
Authorized Official
Title or Position : PRESIDENT
Name : MR. BRUCE MARC GOODHEART
Credential : P.T.
Telephone Number : 516-569-0373
Provider Enumeration Date : 05/31/2005
Last Update Date : 11/01/2013

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