Healthcare Provider Details

I. General information

NPI: 1083620710
Provider Name (Legal Business Name): HEATHER MARCY SPOTTISWOOD P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER MARCY STEIN PT

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HEMPSTEAD TPKE
EAST MEADOW NY
11554-1859
US

IV. Provider business mailing address

3012 BOND DR
MERRICK NY
11566-5125
US

V. Phone/Fax

Practice location:
  • Phone: 516-486-6862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number012243
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: