Healthcare Provider Details

I. General information

NPI: 1265267256
Provider Name (Legal Business Name): DOROTA OSTROWSKI PHYSICAL THERAPIST P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2024
Last Update Date: 09/07/2024
Certification Date: 09/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PAWNEE DR
COMMACK NY
11725-4210
US

IV. Provider business mailing address

15 PAWNEE DR
COMMACK NY
11725-4210
US

V. Phone/Fax

Practice location:
  • Phone: 631-879-8336
  • Fax:
Mailing address:
  • Phone: 631-879-8336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DOROTA OSTROWSKI
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 631-879-8336