MEDICARE: SHERRY BIEBER PT, DPT

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	035873	NY

General Provider Information

NPI Number	:	1245580513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY BIEBER PT, DPT

Provider Business Mailing Address
First Line	:	611 OLD WILLETS PATH, SUITE 105
Second Line	:
City	:	HAUPPAUGE
State	:	NY
Zip	:	11788-4115
Country	:	US
Telephone Number	:	631-232-5350
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 TECHNOLOGY DR UNIT 2
Second Line	:
City	:	EAST SETAUKET
State	:	NY
Zip	:	11733-4049
Country	:	US
Telephone Number	:	631-444-5041
Fax Number	:

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

Provider Enumeration Date	:	09/14/2012
Last Update Date	:	07/15/2024

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