Healthcare Provider Details

I. General information

NPI: 1205981727
Provider Name (Legal Business Name): SOUND THERAPEUTICS PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 ROUTE 25A
MILLER PLACE NY
11764-2643
US

IV. Provider business mailing address

691 ROUTE 25A P.O. BOX 2013
MILLER PLACE NY
11764-2643
US

V. Phone/Fax

Practice location:
  • Phone: 631-821-7337
  • Fax: 631-821-3588
Mailing address:
  • Phone: 631-821-7337
  • Fax: 631-821-3588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER PICCOLO
Title or Position: DIR. OF PERSONEL, HIPAA COMPLIANCE
Credential:
Phone: 631-821-7337