Healthcare Provider Details

I. General information

NPI: 1376783720
Provider Name (Legal Business Name): PATHWAYS PHYSICAL & OCCUPATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 SUNRISE HWY
LYNBROOK NY
11563-2922
US

IV. Provider business mailing address

815 SUNRISE HWY
LYNBROOK NY
11563-2922
US

V. Phone/Fax

Practice location:
  • Phone: 516-660-3911
  • Fax: 516-599-1021
Mailing address:
  • Phone: 516-660-3911
  • Fax: 516-599-1021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number005950-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number005250-1
License Number StateNY

VIII. Authorized Official

Name: MS. MONICA MOSKOWITZ
Title or Position: PHYSICAL THERAPIST/ ORGANIZER
Credential: P.T.
Phone: 516-524-4670