Healthcare Provider Details

I. General information

NPI: 1184507352
Provider Name (Legal Business Name): JEFFREY P GOLDSTEIN OTR PT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 BOARDWALK UNIT 819
LONG BEACH NY
11561-6916
US

IV. Provider business mailing address

180 BOARDWALK UNIT 819
LONG BEACH NY
11561-6916
US

V. Phone/Fax

Practice location:
  • Phone: 516-238-0294
  • Fax: 516-897-5399
Mailing address:
  • Phone: 516-238-0294
  • Fax: 516-897-5399

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: STEVEN VEROXIE
Title or Position: OFFICE ADMIN
Credential:
Phone: 516-780-0132