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NPI Code Detail

MEDICARE: CHARMEL PHYSICAL THERAPY OF NEW YORK, PLLC

MEDICARE: CHARMEL PHYSICAL THERAPY OF NEW YORK, PLLC
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
1225100000XPhysical Therapist029130NY

General Provider Information

NPI Number : 1528386570
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARMEL PHYSICAL THERAPY OF NEW YORK, PLLC
Provider Business Mailing Address
First Line : 1200 W BROADWAY
Second Line : SUITE 1
City : HEWLETT
State : NY
Zip : 11557-1913
Country : US
Telephone Number : 516-374-5934
Fax Number : 888-878-8076
Provider Business Practice Location Address
First Line : 1200 W BROADWAY
Second Line : SUITE 1
City : HEWLETT
State : NY
Zip : 11557-1913
Country : US
Telephone Number : 516-374-5934
Fax Number : 888-878-8076
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : MS. MARY CHARMEL MORALES SAMONTE
Credential : PT, DPT
Telephone Number : 516-374-5934
Provider Enumeration Date : 05/13/2010
Last Update Date : 08/12/2015

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