Healthcare Provider Details

I. General information

NPI: 1245142512
Provider Name (Legal Business Name): PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 HEMPSTEAD TPKE STE B
FARMINGDALE NY
11735-2046
US

IV. Provider business mailing address

576 BROADHOLLOW RD
MELVILLE NY
11747-5012
US

V. Phone/Fax

Practice location:
  • Phone: 516-755-7808
  • Fax: 516-755-7809
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KERRI WILKINSON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 631-359-5859