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NPI Code Detail

MEDICARE: SAUNDRA J PERRY RPT PC

MEDICARE: SAUNDRA J PERRY RPT 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
1225100000XPhysical Therapist06894NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A2527929OTHERNYORTHONET

General Provider Information

NPI Number : 1740226679
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAUNDRA J PERRY RPT PC
Provider Business Mailing Address
First Line : 57190 MAIN RD
Second Line : PO BOX 1824
City : SOUTHOLD
State : NY
Zip : 11971-4750
Country : US
Telephone Number : 631-765-3620
Fax Number : 631-765-0013
Provider Business Practice Location Address
First Line : 57190 MAIN RD
Second Line :
City : SOUTHOLD
State : NY
Zip : 11971-4750
Country : US
Telephone Number : 631-765-3620
Fax Number : 631-765-0013
Authorized Official
Title or Position : OWNER/CEO
Name : MS. SAUNDRA J PERRY
Credential : P.T..
Telephone Number : 631-765-3620
Provider Enumeration Date : 06/20/2006
Last Update Date : 05/27/2009

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