Healthcare Provider Details

I. General information

NPI: 1144674037
Provider Name (Legal Business Name): VERTEX PHYSICAL THERAPY SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 W SUFFOLK AVENUE
CENTRAL ISLIP NY
11722-2144
US

IV. Provider business mailing address

46 W SUFFOLK AVENUE
CENTRAL ISLIP NY
11722-2144
US

V. Phone/Fax

Practice location:
  • Phone: 407-758-3923
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: HONEY BELLE HUGO
Title or Position: OWNER
Credential:
Phone: 407-758-3923