MEDICARE: PIERRE C UYBARRETA PT

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
1	225100000X	Physical Therapist	0208571	NY

General Provider Information

NPI Number	:	1194816710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERRE C UYBARRETA PT

Provider Business Mailing Address
First Line	:	6 AVON CT
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-6101
Country	:	US
Telephone Number	:	516-921-3576
Fax Number	:	631-422-3723

Provider Business Practice Location Address
First Line	:	400 W MAIN ST STE 111
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-3009
Country	:	US
Telephone Number	:	631-376-0600
Fax Number	:	631-422-3723

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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Directions to “ PIERRE C UYBARRETA PT” Practice Location

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